背景:在全髋关节置换术中,后外侧入路被认为在全髋关节置换术后脱位率高于其他手术入路,但后路软组织修复技术弥补了这一局限性。目前临床上应用的修复技术主要为经骨修复技术(TBRT)、经肌腱修复技术(TTRT)以及经锚钉修复技术(TART),尽...背景:在全髋关节置换术中,后外侧入路被认为在全髋关节置换术后脱位率高于其他手术入路,但后路软组织修复技术弥补了这一局限性。目前临床上应用的修复技术主要为经骨修复技术(TBRT)、经肌腱修复技术(TTRT)以及经锚钉修复技术(TART),尽管目前的研究提供了充分的TBRT和TTRT修复后方软组织的结果报道,但对于最佳的后方软组织修复技术骨科医生尚无法达成共识。本综述论述各种后方软组织修复技术的修复结果,并且比较了TBRT与TTRT两种修复技术的修复结果。结果:在行后入路THA中对后方软组织行TBRT与TTRT修复后方软组织对降低术后脱位率是有效的。行TBRT的有效性优于行TTRT修复。此外,对后关节囊进行修复也能有效降低术后脱位率。Background: In total hip arthroplasty, the posterolateral approach is thought to have a higher rate of dislocation after total hip arthroplasty than other surgical approaches, but posterior soft tissue repair techniques compensate for this limitation. Currently, the clinically used repair techniques are mainly through-bone repair technique (TBRT), through-tendon repair technique (TTRT), and through-anchor repair technique (TART). Although current studies have provided sufficient reports on the results of TBRT and TTRT repair of the posterior soft tissue, there is no consensus among orthopedic surgeons on the optimal technique of soft tissue repair. This review discusses the repair results of various posterior soft tissue repair techniques and compares the repair results of TBRT and TTRT repair techniques. Results: TBRT and TTRT in posterior soft tissue repair in posterior approach THA were effective in reducing postoperative dislocation rate. The effectiveness of TBRT is better than that of TTRT repair. In addition, the repair of the posterior joint capsule can also effectively reduce the postoperative dislocation rate.展开更多
BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene ma...BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene manipulation for the treatment of osteoarthritis may not produce satisfactory results.Previous studies have shown that nuclear factorκB could promote the inflammatory pathway in osteoarthritic chondrocytes,and bone morphogenetic protein 4(BMP4)could promote cartilage regeneration.OBJECTIVE:To test whether combined application of AAV-p65shRNA and AAV-BMP4 will yield the synergistic effect on chondrocytes regeneration and osteoarthritis treatment.METHODS:Viral particles containing AAV-p65-shRNA and AAV-BMP4 were prepared.Their efficacy in inhibiting inflammation in chondrocytes and promoting chondrogenesis was assessed in vitro and in vivo by transfecting AAV-p65-shRNA or AAV-BMP4 into cells.The experiments were divided into five groups:PBS group;osteoarthritis group;AAV-BMP4 group;AAV-p65shRNA group;and BMP4-p65shRNA 1:1 group.Samples were collected at 4,12,and 24 weeks postoperatively.Tissue staining,including safranin O and Alcian blue,was applied after collecting articular tissue.Then,the optimal ratio between the two types of transfected viral particles was further investigated to improve the chondrogenic potential of mixed cells in vivo.RESULTS AND CONCLUSION:The combined application of AAV-p65shRNA and AAV-BMP4 together showed a synergistic effect on cartilage regeneration and osteoarthritis treatment.Mixed cells transfected with AAV-p65shRNA and AAV-BMP4 at a 1:1 ratio produced the most extracellular matrix synthesis(P<0.05).In vivo results also revealed that the combination of the two viruses had the highest regenerative potential for osteoarthritic cartilage(P<0.05).In the present study,we also discovered that the combined therapy had the maximum effect when the two viruses were administered in equal proportions.Decreasing either p65shRNA or BMP4 transfected cells resulted in less collagen II synthesis.This implies that inhibiting inflammation by p65shRNA and promoting regeneration by BMP4 are equally important for osteoarthritis treatment.These findings provide a new strategy for the treatment of early osteoarthritis by simultaneously inhibiting cartilage inflammation and promoting cartilage repair.展开更多
髌骨脱位主要是指由于先天或后天因素造成髌骨向外脱位或半脱位,这种情况是一种普遍存在的膝盖伤害,尤其在青少年群体中更为严重。在髌骨发生弯曲或者旋转的过程中,有可能造成软组织的破坏、局部的膨胀以及疼痛,更有可能引发软骨的磨损...髌骨脱位主要是指由于先天或后天因素造成髌骨向外脱位或半脱位,这种情况是一种普遍存在的膝盖伤害,尤其在青少年群体中更为严重。在髌骨发生弯曲或者旋转的过程中,有可能造成软组织的破坏、局部的膨胀以及疼痛,更有可能引发软骨的磨损,这将对日常生活产生极大的负面效应。这篇文章的核心是对内侧髌股韧带的解剖和重建手术的方法进行概述,以便给临床医生提供借鉴。Patellar dislocation mainly refers to the outward dislocation or subluxation of the patella due to congenital or acquired factors. This is a common knee injury, especially in adolescents. During the bending or rotation of the patella, it may cause soft tissue damage, local swelling and pain, and it is more likely to cause cartilage wear, which will have a great negative effect on daily life. The core of this article is to provide an overview of the anatomy and reconstruction methods of the medial patellofemoral ligament in order to provide a reference for clinicians.展开更多
前列腺癌是男性恶性肿瘤中最常见的肿瘤之一,目前根治性前列腺切除术是治疗器官局限性及局部进展期前列腺癌的最主要手段。然而在手术后部分患者会出现切缘阳性,这有可能导致前列腺癌的生化复发甚至临床进展,因此有效的治疗和预测策略...前列腺癌是男性恶性肿瘤中最常见的肿瘤之一,目前根治性前列腺切除术是治疗器官局限性及局部进展期前列腺癌的最主要手段。然而在手术后部分患者会出现切缘阳性,这有可能导致前列腺癌的生化复发甚至临床进展,因此有效的治疗和预测策略对改善患者预后至关重要。本文概述切缘阳性患者在根治前列腺切除后的最新诊治及预后,为这类病人的预防和治疗提供思路。Radical prostatectomy is the primary treatment for organ-confined and locally advanced prostate cancer, a malignancy that is one of the most frequent among men. Despite the possibility of positive surgical margins postoperatively, this may result in biochemical recurrence or even a clinical progression of prostate cancer. Therefore, effective treatment and predictive strategies are crucial for improving patient outcomes. The aim of this article is to provide an overview of the most recent progressions in diagnosing, treating, and forecasting those with positive surgical margins after radical prostatectomy, thereby offering insight into how to avert and treat them.展开更多
文摘背景:在全髋关节置换术中,后外侧入路被认为在全髋关节置换术后脱位率高于其他手术入路,但后路软组织修复技术弥补了这一局限性。目前临床上应用的修复技术主要为经骨修复技术(TBRT)、经肌腱修复技术(TTRT)以及经锚钉修复技术(TART),尽管目前的研究提供了充分的TBRT和TTRT修复后方软组织的结果报道,但对于最佳的后方软组织修复技术骨科医生尚无法达成共识。本综述论述各种后方软组织修复技术的修复结果,并且比较了TBRT与TTRT两种修复技术的修复结果。结果:在行后入路THA中对后方软组织行TBRT与TTRT修复后方软组织对降低术后脱位率是有效的。行TBRT的有效性优于行TTRT修复。此外,对后关节囊进行修复也能有效降低术后脱位率。Background: In total hip arthroplasty, the posterolateral approach is thought to have a higher rate of dislocation after total hip arthroplasty than other surgical approaches, but posterior soft tissue repair techniques compensate for this limitation. Currently, the clinically used repair techniques are mainly through-bone repair technique (TBRT), through-tendon repair technique (TTRT), and through-anchor repair technique (TART). Although current studies have provided sufficient reports on the results of TBRT and TTRT repair of the posterior soft tissue, there is no consensus among orthopedic surgeons on the optimal technique of soft tissue repair. This review discusses the repair results of various posterior soft tissue repair techniques and compares the repair results of TBRT and TTRT repair techniques. Results: TBRT and TTRT in posterior soft tissue repair in posterior approach THA were effective in reducing postoperative dislocation rate. The effectiveness of TBRT is better than that of TTRT repair. In addition, the repair of the posterior joint capsule can also effectively reduce the postoperative dislocation rate.
文摘BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene manipulation for the treatment of osteoarthritis may not produce satisfactory results.Previous studies have shown that nuclear factorκB could promote the inflammatory pathway in osteoarthritic chondrocytes,and bone morphogenetic protein 4(BMP4)could promote cartilage regeneration.OBJECTIVE:To test whether combined application of AAV-p65shRNA and AAV-BMP4 will yield the synergistic effect on chondrocytes regeneration and osteoarthritis treatment.METHODS:Viral particles containing AAV-p65-shRNA and AAV-BMP4 were prepared.Their efficacy in inhibiting inflammation in chondrocytes and promoting chondrogenesis was assessed in vitro and in vivo by transfecting AAV-p65-shRNA or AAV-BMP4 into cells.The experiments were divided into five groups:PBS group;osteoarthritis group;AAV-BMP4 group;AAV-p65shRNA group;and BMP4-p65shRNA 1:1 group.Samples were collected at 4,12,and 24 weeks postoperatively.Tissue staining,including safranin O and Alcian blue,was applied after collecting articular tissue.Then,the optimal ratio between the two types of transfected viral particles was further investigated to improve the chondrogenic potential of mixed cells in vivo.RESULTS AND CONCLUSION:The combined application of AAV-p65shRNA and AAV-BMP4 together showed a synergistic effect on cartilage regeneration and osteoarthritis treatment.Mixed cells transfected with AAV-p65shRNA and AAV-BMP4 at a 1:1 ratio produced the most extracellular matrix synthesis(P<0.05).In vivo results also revealed that the combination of the two viruses had the highest regenerative potential for osteoarthritic cartilage(P<0.05).In the present study,we also discovered that the combined therapy had the maximum effect when the two viruses were administered in equal proportions.Decreasing either p65shRNA or BMP4 transfected cells resulted in less collagen II synthesis.This implies that inhibiting inflammation by p65shRNA and promoting regeneration by BMP4 are equally important for osteoarthritis treatment.These findings provide a new strategy for the treatment of early osteoarthritis by simultaneously inhibiting cartilage inflammation and promoting cartilage repair.
文摘髌骨脱位主要是指由于先天或后天因素造成髌骨向外脱位或半脱位,这种情况是一种普遍存在的膝盖伤害,尤其在青少年群体中更为严重。在髌骨发生弯曲或者旋转的过程中,有可能造成软组织的破坏、局部的膨胀以及疼痛,更有可能引发软骨的磨损,这将对日常生活产生极大的负面效应。这篇文章的核心是对内侧髌股韧带的解剖和重建手术的方法进行概述,以便给临床医生提供借鉴。Patellar dislocation mainly refers to the outward dislocation or subluxation of the patella due to congenital or acquired factors. This is a common knee injury, especially in adolescents. During the bending or rotation of the patella, it may cause soft tissue damage, local swelling and pain, and it is more likely to cause cartilage wear, which will have a great negative effect on daily life. The core of this article is to provide an overview of the anatomy and reconstruction methods of the medial patellofemoral ligament in order to provide a reference for clinicians.
文摘前列腺癌是男性恶性肿瘤中最常见的肿瘤之一,目前根治性前列腺切除术是治疗器官局限性及局部进展期前列腺癌的最主要手段。然而在手术后部分患者会出现切缘阳性,这有可能导致前列腺癌的生化复发甚至临床进展,因此有效的治疗和预测策略对改善患者预后至关重要。本文概述切缘阳性患者在根治前列腺切除后的最新诊治及预后,为这类病人的预防和治疗提供思路。Radical prostatectomy is the primary treatment for organ-confined and locally advanced prostate cancer, a malignancy that is one of the most frequent among men. Despite the possibility of positive surgical margins postoperatively, this may result in biochemical recurrence or even a clinical progression of prostate cancer. Therefore, effective treatment and predictive strategies are crucial for improving patient outcomes. The aim of this article is to provide an overview of the most recent progressions in diagnosing, treating, and forecasting those with positive surgical margins after radical prostatectomy, thereby offering insight into how to avert and treat them.
