Experimental Evaluation of Strain Shielding in Distal Femur in Revision TKA

Theoretical concerns about the use of cemented and press-fit stems in revision total knee arthroplasty (TKA) include stress shielding with adverse effects on prosthesis fixation. Radiological studies have showed distal femoral bone resorption after revision TKA. The revision with use of stems can place abnormal stresses. These stresses can promote the effect of bone stress shielding and may contribute to bone loss. Experimental quantification of strain shielding in the distal synthetic femur following TKA is the main purpose of the present study. Three different constructs of TKA were assessed. The first construct included a stemless femoral component. The other two included a press-fit and a cemented femoral stem. Cortical bone strains were measured experimentally with tri-axial strain gauges in synthetic femurs before and after in-vitro knee surgery. The difference between principal strains of implanted and intact femur was calculated for each strain gauge position. This study indicates that the use of stems in distal femur changes the distribution and magnitude of bone strains. The press-fit stem provoked relevant bone area (stem length) subjected to strain shielding and also originated the highest reduction of strains in the distal region, which can potentially induce bone resorption. The stemless implanted femur produced minor bone strain changes relatively to the intact femur. The use of distal femur stems increases initial stability in the bone, but the observed reduction of strains in this region, relative to the intact femur, provokes strain shielding that can induce bone resorption and may compromise the long term implant stability.     

Thermal analysis of the cruciate ligaments of the human knee

Summary Cruciate ligaments of the knee joint are important structures very often affected by the degenerative process in case of osteoarthritis. One of the most controversial issues in knee arthroplasty practice nowadays is the role of the posterior cruciate ligament. With foregoing studies authors have demonstrated the feasibility of DSC in the investigation of the musculoskeletal system. With current study authors established the thermal behaviour of healthy cruciate ligaments and detected the alterations in case of osteoarthritis. By establishing the DSC scans of the normal ligaments authors demonstrated clear differences between the posterior and anterior ligament. In addition alterations between normal and arthritic samples could be detected both in terms of changes in total enthalpy and heat capacity. Calorimetric findings have been verified by histological examinations as well.     

一站式CT检查系统在急性胸痛患者干预方案中的应用

本研究探讨一站式CT检查系统在急性胸痛患者管理中干预方案的应用。将符合急性胸痛患者49例纳入研究,采用自动触发方式采集患者上胸部volume数据集和心胸部volume数据集,经过处理后获得胸主动脉、冠状动脉、肺动脉及全胸部图像。本研究中,测量结果发现平均CT值主动脉弓是(332±51)Hu,升主动脉是(435±53)Hu,肺动脉干是(491±93)Hu,降主动脉是(454±70)Hu,而左冠状动脉和右冠状动脉分别是(425±60)Hu、(415±62)Hu。病变鉴定发现,急性肺栓塞12例,主动脉弓动脉粥样硬化斑块破裂8例,肺组织实变4例,慢性肺栓塞伴右心衰竭2例,胸腔积液2例,左冠状动脉非关键性狭窄11例,右冠状动脉非关键性狭窄7例,心包积液2例,复合解剖畸形1例。总之,本研究通过一站式CT检查系统对急性胸痛患者干预方案的制定提供了重要指导。     

In Vitro Cytotoxic Protective Effect of Alginate-Encapsulated Capsaicin Might Improve Skin Side Effects Associated with the Topical Application of Capsaicin

Chronic neuropathic pain, particularly peripheral pain, is a cause of great concern for diabetic patients. Current treatments include numerous agents such as capsaicinoids, a known deterrent of neuropathic pain despite the inconvenience associated with local side effects. In this context, the current work aims to elucidate the potential mechanisms involved in cytotoxicity by capsaicin and proposes an efficient formulation of capsaicin in alginate microcapsules, which significantly reduces side effects from capsaicin topical administration. For this, human dermal fibroblast cells were treated with alginate-microencapsulated capsaicin extracts and screened for potential cytotoxic effects produced by the treatment. Cell viability and morphology were examined, as well as oxidative stress status and anti-inflammatory potential. Our results show that the alginate encapsulated formulation of capsaicin exerted lower cytotoxic effects on human dermal fibroblasts as measured by cell viability and reactive oxygen species (ROS) production. Furthermore, the expression profiles of inflammatory cytokines were significantly altered by the treatment as compared with the control culture.     

4T split TEM volume head and knee coils for improved sensitivity and patient accessibility

Split RF coils offer improved patient access by eliminating the need for the coil to be slid over the region of interest. For unshielded birdcage coils, the presence of end ring currents necessitates a direct electrical connection between two halves of the coil. For high-field (>3T) shielded birdcage coils, both the shield and the coil must be split and reliably connected electrically. This problem can be circumvented by the use of split TEM volume coils. Since the elements of a TEM coil are coupled inductively, no direct electrical connection between the halves is necessary. In this work we demonstrate that the effects of splitting the shield for head and knee TEMs can be compensated for, and performance retained. For the knee, the improved access allowed the coil diameter to be reduced, enhancing the sensitivity by 15-20%.     

Inhibition of Thiol-Mediated Uptake with Irreversible Covalent Inhibitors

Thiol-mediated uptake is emerging as method of choice to penetrate cells. This study focuses on irreversible covalent inhibitors of thiol-mediated uptake. High-content high-throughput screening of the so far largest collection of hypervalent iodine reagents affords inhibitors that are more than 250 times more active than Ellman’s reagent and rival the best dynamic covalent inhibitors. Comparison with other irreversible reagents reveals that inhibition within one series follows reactivity, whereas inhibition across series deviates from reactivity. These trends support that molecular recognition, besides dynamic covalent exchange, contributes significantly to thiol-mediated uptake. The most powerful inhibitors besides the best hypervalent iodine reagents were Fukuyama’s nosyl protecting group and super-cinnamaldehydes that have been introduced as irreversible activators of the pain receptor TRPA1. Considering that several viruses use different forms of thiol-mediated uptake to enter cells, the identification of new irreversible inhibitors of thiol-mediated uptake is of general interest for the discovery of new antivirals.     

两种药物膀胱灌注治疗间质性膀胱炎的临床疗效观察

目的 观察并比较透明质酸钠、碱化利多卡因联合肝素膀胱灌注治疗膀胱疼痛综合征/ 间质性膀胱炎（BPS/IC）的临 床疗效。方法 将63 例BPS/IC 患者按随机单盲的原则分成A、B 两组,A 组32 例,B 组31 例。A 组患者予膀胱灌注透明质酸钠40ml;B 组予膀胱灌注碱化利多卡因联合肝素治疗,即用5%碳酸氢钠10ml、2%利多卡因10ml、肝素钠2.5 万U 和0.9%氯化钠15ml的混合液行膀胱灌注。两组均保留40~60min,每周2 次,4周后改为每周1 次,共16 次。观察两组患者用药前及用药开始后4、12周时的O’Leary-Sant平均症状评分（ICPI）、问题评分（ICSI）及生活质量评分（QOL）,并记录不良反应。结果 两组患者治疗开始后4周和12 周ICPI、ICSI 及QOL评分均有明显改善,与治疗前比较均有统计学差异（均P＜0.05）。治疗4 周后两组的ICPI、ICSI 及QOL 评分下降分值比较均无统计学差异（均P＞0.05）,但治疗12 周后A 组的ICPI、ICSI 及QOL评分下降分值较B 组更为明显（均P＜0.05）。所有患者治疗过程中均未发生明显不良反应。结论 透明质酸钠及碱化利多卡因联合肝素膀胱灌注均能改善BPS/IC患者的临床症状,而透明质酸钠疗效更为显著。     

Effect of Interventions for Improving Lumbar Motor Control on Low Back Pain in Sedentary Office Workers: A Randomized Controlled Trials

Objective: To clarify the effect of intervention with dynamic motor control exercise (DMCE) for the lumbar region on low back pain in sedentary office workers (SOWs). Methods: The participants comprised 32 SOWs with low back pain who were randomly categorized into two groups: the DMCE group and the normal trunk exercise (NTE) group. Both groups performed each exercise for three days per week for 8 weeks. The primary endpoints were evaluated for the lumbar and hip flexion angles during trunk forward bending, effect of low back pain on activities of daily living (using the Oswestry Disability Index), and intensity of low back pain (using the Visual Analog Scale) pre- and post-intervention. The extent of changes was calculated by subtracting the pre-intervention value from the post-intervention value and was compared between the two groups using an unpaired t-test. Results: The extent of changes in the lumbar flexion and hip flexion angles at 10° of trunk forward bending were significantly greater in the DMCE group than in the NTE group, and no significant differences were noted between the two groups at other angles of trunk forward bending. The extent of changes in the Oswestry Disability Index and the Visual Analog Scale scores were significantly greater in the DMCE group than in the NTE group. Conclusion: DMCE is effective in improving motor control in the lumbar region and hip joints, thereby ameliorating low back pain in SOWs.     

Electromyography Activity of Vastus Medialis Obliquus and Vastus Lateralis Muscles During Lower Limb Proprioceptive Neuromuscular Facilitation Patterns in Individuals with and without Patellofemoral Pain Syndrome

Objective: Exercise therapy to strengthen quadriceps muscle is recommended in rehabilitation program for people with patellofemoral pain syndrome (PFPS). This study aimed to investigate the electromyography (EMG) activity of vastus medialis obliquus (VMO), vastus lateralis (VL) and VMO/VL ratio during PNF in individuals with and without PFPS. Methods: 26 persons with PFPS and 26 healthy subjects participated to study. All subjects performed PNF patterns (Flexion-Adduction-External Rotation (D₁FL), Extension-Adduction-External Rotation (D₂EX), D₁FL+ load, D₂EX+ load) and straight leg raise (SLR). The normalized EMG activity of VMO, VL and VMO/VL ratio were measured and analyzed using repeated measure ANOVA. Results: There were significant main effects of group and exercises for the both VMO and VL (p<0.05). It was found that except SLR and D₂EX, in the other motions PFPS group had lower VMO activity compared to healthy group (p<0.05). For VL except SLR, in the other motions PFPS group had lower VL activity too (p<0.05). The PNF patterns activated VMO more than SLR, however it was not significant (p>0.05). Also; there weren''t any significant difference between the two groups in VMO/VL activation ratios. Also, performing the PNF patterns with load increased VMO and VL muscles activity significantly (p<0.05). It also found that in PFPS group the VMO/VL ratio values in PNF patterns were significantly more than SLR and the highest VMO/VL ratio value (0.96) was found during D₂EX. Conclusion: The PNF patterns due to provide optimal VMO/VL ratio value than SLR and proper balance between these two muscles can be recommended in rehabilitation of individuals with PFPS.     

Dynamics of strong-field double ionization of H_2 in co-rotating two-color circularly polarized laser fields

Double ionization of H_2 in a co-rotating two-color circularly polarized(TCCP) laser field is theoretically investigated. By changing the ratio of electric field peak amplitudes of the TCCP laser pulses, the double ionization probability as a function of the laser intensity shows a clear knee structure, which is suppressed significantly in the case of the atom. Due to the large spatial range of the electronic initial distribution, with the analysis of classical trajectories of ionized electrons, it is found that the ionization of the electron in the farther distance increases the probability of recollision. Furthermore, the yield of nonsequential double ionization created by the recollision can be enhanced by controlling the amplitude ratio of the TCCP laser field.