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Hip surgery has been a slow-growing specialty in orthopedics and sports medicine. The development of imaging and minimally invasive arthroscopic surgery techniques has brought opportunities for this branch. Compared with other minimally invasive joint techniques, hip arthroscopy develops more slowly due to high equipment requirements, difficult operation and long learning curve. However, with continuous breakthroughs in disease diagnosis and surgical techniques, hip arthroscopy technology has stayed in a fast track for the past 20 years, and has become the most rapidly developed field in sports medicine. Especially in the past decade, China's hip arthroscopy society has developed rapidly in both surgery volumes and types. With an increasing population of hip doctors, the technical level and related research gap between China and the outside world narrowed. In some research fields, China even surpassed them. In general, both domestic and overseas studies show that the effect of hip arthroscopy is positive with significant improvement of symptoms in most patients. However, some patients complained poor recovery and residual hip pain, which indicates that hip diseases are still not totally understood, and the development of hip arthroscopy technology is still in an early stage. Therefore, accurate diagnosis and indication selection, detailed assessment of patients' exercise needs and psychological status, perfect preoperative planning, skilled surgical operation, and strict functional rehabilitation are the keys to success, which should be kept in mind by every hip arthroscopy doctor. They are also the main research direction for hip arthroscopy doctors. Continuous efforts on clinical and basic research should be made for the development of hip arthroscopy to establish a more optimized and comprehensive diagnosis and treatment system.
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Femoral acetabular impingement (FAI) is a condition characterized by abnormal anatomical structures of the femoral head and/or acetabulum, leading to impingement between the proximal femur and the rim of the acetabulum during hip movement. This impingement causes damage to the acetabular cartilage, labrum, chronic hip pain, and limited range of motion. The diagnosis of this condition requires evaluation based on symptoms, physical signs, and imaging examinations. Among these, imaging plays a crucial role in assessing the pathology of FAI. In recent years, imaging techniques have contributed to a deeper understanding of the mechanisms underlying FAI and the development of hip-preserving surgeries. The purpose of this paper is to provide a reference for the imaging-related diagnosis and measurement of FAI. X-ray films include pelvic anteroposterior view, false-profile view and 45°Dunn view. Doctors can understand the anatomical morphology of the femur and acetabulum by measuring relevant indicators in the X-ray films. For example, the α Angle of the femur >50°-60 ° in the pelvic anteroposterior view can indicate CAM-type FAI. However, the crisscross sign, posterior wall sign and LCE Angle >40° suggest Pincer type FAI. The ACE Angle, which reflects the anterior coverage of the acetabulum, was mainly measured on the false-profile view. The ACE Angle <20° is considered as insufficient anterior acetabular coverage, and acetabular dysplasia may be present.If it >40° is the anterior acetabular overcoverage, suggesting pincer-type FAI. The 45°Dunn view is mainly used to show the femoral head and neck deformity at 3 o'clock, where the femoroacetabular impingement is obvious. This position has a good indication effect for CAM-type FAI. CT can show the shape of the hip joint more intuitively by three-dimensional reconstruction of the patient's hip joint, which is convenient for surgical planning and postoperative evaluation. In addition, CT can also be used for the differential diagnosis of external hip impingement, such as ischiofemoral impingement, anterior inferior iliac spine impingement and greatertrochanteric impingement. MR Has excellent soft tissue imaging ability and can show other lesions that are difficult to be found by X-ray and CT, such as acetabular labrum and cartilage injury. It is essential for preoperative evaluation. Appropriate imaging examination plays a key role in the diagnosis and treatment of FAI.
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Objective To investigate the effect of minocycline on development of diabetic neuropathic pain in rats and its mechanism.Methods Forty male Sprague-Dawley rats aged 6-8 weeks,weighting 180-220 g,were randomly assigned into 4 groups,with 10 rats in each group:normal control group (group C),normal+minocycline group (group C+M),diabetes mellitus group (group DM),diabetes+minocycline group (group DM+M).Diabetes models of rats in group DM and group DM+M were established by single intraperitoneal injection of streptozotocin (STZ,65 mg/kg),and equal volume of normal saline was injected instead of STZ into group C and group C+M;the fasting blood glucose level was tested every week,and the rats of blood glucose level ≥ 16.6 mmol/L were selected otherwise by additional injection of STZ.Two weeks after that,the intervention treatment of rats was given by single intraperitoneal injection ofminocycline (40 mg/kg) in group DM+M and group C+M.The thermal tail flick latency (TFL),thermal withdrawal latency (TWL) and mechanical withdrawal threshold (MWT) were detected one day prior to the injection of STZ (T0),and one (T1),2 (T2),4 (T3) and 8 (T4) weeks after the injection of STZ.Eight weeks after that,the expressions of malondialdehyde (MDA) and superoxide dismutase (SOD) in the spinal dorsal ofthe rats were detected by principles ofphysical chemistry with enzyme standard instrument,and apoptotic cells in dorsal hom was detected by immunohistochemistry.Results As compared with those in group C and group C+M,TFL,TWL and MWT in group DM and group DM+M were significantly decreased at T2,T3 and T4 (P＜0.05);TFL,TWL and MWT in group DM+M were significantly increased as compared with those in group DM,reaching their peak levels at T4,with significant differences (P＜0.05).SOD level in group D and group DM was significantly lower than that in group C (P＜0.05),and MDA level in group D and group DM was significantly higher than that in group C (P＜0.05);as compared with group DM,group DM+M had higher SOD level and lower MDA level,with significant differences (P＜0.05).The number of apoptotic cells in spinal dorsal of the rats in group DM was significantly larger than that in group C (P＜0.05).Conclusion Minocycline can relieve diabetic neuropathy pain,and the underlying of mechanisms may be through anti-inflammatory,anti-oxidant stress,anti-apoptosis,and reducing the microglia activation in the spinal cord.
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Objective To explore the effects of different doses of dexmedetomidine on acute brain edema in mice with traumatic brain injury (TBI).Methods A total of 132 male C57BL/6J mice were randomly divided into six groups:control group (group C),sham-operation group (group Sham),traumatic brain injury group (group TBI),Dex 20 μg/kg (group D20),40 μg/kg (group D40),and 60 μg/kg (group D60),n=22 in each group.The TBI animal model was established by electric controlled cortical impactor (eCCI),then intraperitoneal injected by the administration of different doses of dexmedetomidine at 0,2 and 4 h after TBI.Twenty-four hours post-TBI,brain water content was measured by the dry-wet method,histological observation was performed using HE staining,and aquaporin 4 (AQP4) and NF-κB expression were detected using Western blot assay,respectively.Then,the modified neurological scale scores (mNSS) on 1,2,3,and 7 d and Morris water maze (MWM) test on 4,5,6 and 7 d post-TBI were used to evaluate the neurologic deficit of TBI mice.Results After traumatic brain injury,the mNSS scores,the escape latency,the brain water content and the expression of AQP4 and NF-κB increased significantly in group TBI (P＜0.01).Different doses of dexmedetomidine significantly reduced the mNSS scores,the escape latency,the brain water content and the expression of AQP4 and NF-κB (P ＜ 0.05 or P ＜ 0.01).And meanwhile dexrnedetomidine can lessen neuronal degeneration,and inflammation response.Additionally,the effect was remarkably in group D60 compared with group D20 (P ＜ 0.05 or P ＜ 0.01).Conclusion Dexmedetomidine can lessen brain edema and cognition impairment induced with traumatic brain injury,which is a dose-effect relationship within 20-60 μg/kg,and this effect may be related to the downregulation of AQP4 and NF-κB expression.
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BACKGROUND:In previous experiments, a polymer-shel ed microbubble contrast agent was successful y prepared using L-polylactic acid-polyethylene glycol methyl-covered liquid fluorocarbon perfluoropentane, which developed wel in vivo and in vitro under a second harmonic contrast-enhanced ultrasound with a low mechanical index OBJECTIVE:To optimize the conditions for preparing polymer-shel ed microbubble contrast agents with high yield and suitable size. METHODS:The polymer-shel ed microbubble contrast agent containing perfluoropentane was prepared by single emulsion method. Three preparation conditions, including polymer mass/perfluoropentane volume ratio (4/1, 2/1, 1/1, 1/2), hemogenate speed (18 000, 26 000, 35 000 r/min) and time (15, 30, 60, 120 seconds), were optimized, and the microbubble yield and size were set as judge standard. The contrast-enhanced ultrasonography of rabbit kidney was performed using the optimized microbubbles, and the arrival time, time to peak, half time of descending and peak intensity were analyzed by TCA software. RESULTS AND CONCLUSION:The preparation conditions were optimized as a polymer mass/perfluoropentane volume ratio of 2/1, homogenate speed of 26 000 r/min and homogenate time of 60 seconds, which presented a high microbubble yield of (1.8±0.4)×109/mL and mean size of (3.7±1.3)μm with uniform distribution. The arrival time, time to peak, half time of descending and peak intensity were detected as (3.1±0.6) seconds, (2.9±0.5) seconds, (4.0±0.7) seconds and (4.7±1.1)×10-5 AU, respectively. The polymeric microbubbles prepared by optimized conditions were of high yield, with suitable size and good contrast-enhanced effect in vivo.
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Objective To evaluate the short-term results of ARCH plate in cerical expansive open-door laminoplasty(ELAP)for OPLL.Methods From June 2010 to September 2011,a total of 12 cases with OPLL underwent open-door ELAP by ARCH plate fixation and were followed up in our hospital.8 cases were males and 4 cases were female.The average age was 60.5 years.The neurological effect was evaluated by use Japanese Orthopedic Association(JOA)scoring criteria for cervical myelopathy.The ana-tomical effect was analyzed by compare roentgenogram and CT before and after surgery.Results The JOA scores were improved for 39% after the operation,while the saggital diameters of the cervical spinal canaldural after operation was enlarged for 82%(P<0.05).X-ray films and CT scan after operation that there was no occurrence of re-close of door,there was no occurrence of anchor loosing.Conclusion For OPLL,ELAP using ARCH plate fixation bring less occurrence of re-close of door,slight postoperative neck AS,and satisfactory clinical outcomes.