Jinmin Zhao

A meta-analysis of hamstring autografts versus bone-patellar tendon-bone autografts for reconstruction of the anterior cruciate ligament.

The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction comparing HT and BPTB autografts. Data analyses were performed with Cochrane Collaborations RevMan 5.0. A total of 23 reports of 19 randomised controlled trials (RCTs) (1643 patients) met the inclusion criteria. Outcomes favouring BPTB autografts were found in terms of KT-1000 arithmometer values, negative rates of Lachman tests and negative rates of Pivot tests. Outcome measures that favoured HT autografts included anterior knee pain, kneeling pain and extension loss. There was no statistical difference of postoperative graft failure. Overall, postoperative complications of the knee joint were lower for HT autografts than for BPTB autografts, and BPTB autografts were superior to HT autografts in resuming stability of the knee joint, but four-strand HT combined with application of the modern endobutton HT graft-fixation technique could increase knee-joint stability.

Systematic review of patellar resurfacing in total knee arthroplasty

Controversies existing over resurfacing the patella in total knee arthroplasty remain in the literature. The purpose of this review was to evaluate the effectiveness of resurfacing versus nonresurfacing the patella in total knee arthroplasty. We searched the Cochrane Library, MEDLINE and EMBASE for published randomised clinical trials relevant to patellar resurfacing. The relative risk of reoperation was significantly lower for the patellar resurfacing group than for the nonresurfacing group (relative risk 0.57, 95% confidence interval 0.38–0.84, P = 0.004). The overall incidence of postoperative anterior knee pain of the 1,421 knees included was 12.9% in the patellar resurfacing group and 24.1% in the nonresurfacing group. The existing evidence indicates that patellar resurfacing can reduce the risk of reoperation with no improvement in postoperative knee function or patient satisfaction over total knee arthroplasty without patellar resurfacing. Whether it can decrease the incidence of anterior knee pain remains uncertain.

Neutrophil CD64 expression as a biomarker in the early diagnosis of bacterial infection: a meta-analysis

BACKGROUND Neutrophil CD64 expression is widely reported as an efficacious biomarker to differentiate infected patients from other non-infected patients. This meta-analysis was conducted to comprehensively and quantitatively summarize the accuracy of neutrophil CD64 in the early diagnosis of bacterial infection. METHODS A systematic review of related studies was conducted, and the sensitivity, specificity, and other data about the accuracy of CD64 expression on neutrophils were pooled using random effects models with 95% confidence intervals (CI) as the effect measurements. Summary receiver operating characteristic (SROC) curves and the Q* value were also calculated in the meta-analysis. Heterogeneity was tested, as well as the publication bias. Potential sources of heterogeneity were explored by assessing whether or not certain covariates significantly influenced the summary diagnostic odds ratio (SDOR). RESULTS A total of 26 studies including 3944 patients met the inclusion criteria for the final analysis. The summary estimate was 0.76 (95% CI 0.74-0.78) for sensitivity and 0.85 (95% CI 0.83-0.86) for specificity. The positive likelihood ratio (PLR), negative likelihood ratio (NLR), SDOR, and area under the SROC of neutrophil CD64 expression with Q* value were 6.67 (95% CI 4.67-9.53), 0.24 (95% CI 0.18-0.31), 34.29 (95% CI 19.59-60.01), and 0.92 (Q*=0.85), respectively. The pooled data from the included studies had high heterogeneity and the Egger test suggested a publication bias. CONCLUSIONS On the basis of our meta-analysis, neutrophil CD64 expression could be a promising and meaningful biomarker for diagnosing bacterial infection. Nevertheless, more large prospective studies should be carried out before the neutrophil CD64 test is used widely in the clinical setting because of the various cut-off values.

Attenuation of Interleukin 2 Signal in the Spleen Cells of Complex Ganglioside-lacking Mice

T cell development and function in complex ganglioside-lacking (GM2/GD2 synthase gene-disrupted) mice were analyzed. GM1, asialo-GM1, and GD1b were representative gangliosides expressed on T cells of the wild type mice and completely deleted on those of the mutant mice. The sizes and cell numbers of the mutant mice spleen and thymus were significantly reduced. Spleen cells from the mutant mice showed clearly reduced proliferation compared with the wild type when stimulated by interleukin 2 (IL-2) but not when treated with concanavalin A or anti-CD3 cross-linking. Expression levels of IL-2 receptor α, β, and γ were almost equivalent, and up-regulation of α chain after T cell activation was also similar between the mutant and wild type mice. Activation of JAK1, JAK3, and SAT5 after IL-2 treatment was reduced, and c-fos expression was delayed and reduced in the mutant spleen cells, suggesting that the IL-2 signal was attenuated in the mutant mice probably due to the modulation of IL-2 receptors by the lack of complex gangliosides.

A report of 15 hand allotransplantations in 12 patients and their outcomes in China.

Background Limb allotransplantation is emerging as a promising solution to the loss of a limb with the development of advanced surgical techniques and new, highly effective immunosuppressive agents. Methods We retrospectively reviewed the records of 15 hand allotransplantations in 12 patients in China which were performed from September 1999 to May 2008. Results In total, there were 1 bilateral and 5 unilateral hand transplantations, 3 unilateral and 2 bilateral forearm transplantations, and 1 palm and 1 thumb transplantation. The average age of recipients was 34 ± 11.3 years (range, 19–52 years). At 1-year follow-up, all grafts were viable and with good function. Of the 15 hands transplanted, 8 are currently viable (mean follow-up, 52 ± 36.3 months; range, 16–112 months), including all 3 bilateral cases. Reasons for graft failure were rejection and failure of compliance with immunosuppressive therapy. Conclusions Long-term survival of hand transplantation with appropriate immunosuppression is feasible, and satisfactory functional results have been achieved. Careful pretransplant psychologic and social evaluation, consideration of the financial burden of long-term immunosuppressive medications, and close multispecialty collaboration is critical for good outcomes. Limb rejection was related with immunosuppression use. Further study and experience is required before hand allotransplantation can become a generally recommended treatment.

Genetic polymorphism of interleukin-16 influences susceptibility to HBV-related hepatocellular carcinoma in a Chinese population

AIM Interleukin-16 (IL16) as a multifunctional cytokine, plays a key role in inflammatory and autoimmune diseases as well as tumour growth and progression. Recently, genetic polymorphisms of IL16 have been reported to be associated with susceptibility to a range of cancers. This study was undertaken to investigate the IL16 gene polymorphisms and determine whether these genetic factors are related to the occurrence of hepatocellular carcinoma (HCC) in a Chinese population. METHODS We analyzed three polymorphisms of the IL16 gene (rs11556218T/G, rs4072111C/T and rs4778889T/C) in 206 patients with HBV-related HCC, 270 chronic hepatitis B patients and 264 healthy controls, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and DNA sequencing technology. RESULTS IL16 polymorphisms were not associated with risk of HCC when compared with healthy controls. However, IL16 polymorphisms were significantly associated with susceptibility to HBV-related HCC when using chronic hepatitis B patients as controls. The rs11556218T/G TG and GG genotypes were associated with significantly increased risk of HBV-related HCC compared with the TT genotype (OR = 1.96 and OR = 3.33). The data also revealed that subjects with the G allele appeared to have higher susceptibility to HBV-related HCC than those with the T allele (OR = 2.10). Under the dominant model genotype TG+GG appeared to be associated with an increased risk of HBV-related HCC (OR = 2.18). The rs4072111C/T TT genotype was associated with a significantly increased risk of HBV-related HCC compared with the CC genotype (OR = 6.67). Polymorphisms of the IL16 gene were significantly associated with susceptibility to chronic hepatitis B when using healthy subjects as controls. The rs11556218T/G TG and GG genotypes were associated with significantly decreased risk of chronic hepatitis B compared with the TT genotype (OR = 0.49 and OR = 0.29). The data also revealed that subjects with the G allele appeared to have lower susceptibility to chronic hepatitis B than those with the T allele (OR = 0.46). Under the dominant model genotype TG + GG appeared to have lower susceptibility to chronic hepatitis B (OR = 0.44). CONCLUSIONS This study showed that the genotypes and allele of IL16 SNPs were associated with chronic HBV infection and HCC. However, further investigation with a larger sample size and haplotype analysis with other SNPs may be required to validate the genetic effects of the IL16 polymorphisms on chronic HBV infection and HCC.

High-Flexion vs Conventional Prostheses Total Knee Arthroplasty: A Meta-Analysis

Whether high-flexion prostheses are superior to conventional prostheses after total knee arthroplasty (TKA) remains controversial. Therefore, this meta-analysis was conducted to evaluate the effects of these 2 different designs. After a comprehensive search, 11 trials with 1204 knees were eligible for data extraction and pooled analysis. The results demonstrated that there were no differences in range of motion of high-flexion posterior-stabilized vs standard posterior-stabilized TKA (weighted mean improvement, 0.93°; 95% confidence intervals, -0.75° to 2.60°; P = .28), range of motion of high-flexion cruciate-retaining vs cruciate-retaining TKA (2.06°; 0.06°-4.17°; P = .06), weight-bearing flexion (2.05°; 0.99°-5.08°; P = .19), Knee Society Scores (1.59 points; 0.42-3.60 points; P = .12), and Hospital for Special Surgery Scores (0.84 points; 0.37-2.04 points; P = .17) with at least 1-year follow-up. No infection, loosening, and osteolysis were found. The current evidences cannot confirm that high-flexion prostheses are superior to conventional prostheses.

Association of IL27 gene polymorphisms and HBV-related hepatocellular carcinoma risk in a Chinese population

BACKGROUND AND OBJECTIVE Hepatocellular carcinoma (HCC) is multifactorial, and the genetic background may be a crucial etiologic factor. Interleukin-27 (IL-27) is a novel IL-12 family member which plays an important role in antitumor immunity. Mutations in the IL27 gene may lead to altered cytokine production and/or activity and thus modulate individuals susceptibility to HCC. In this study, we investigated the association between IL27 gene polymorphisms and HBV-related diseases risk in a Chinese population. METHODS Studied subjects were divided into four groups: 112 patients with chronic hepatitis B (CHB), 65 patients with hepatitis B virus (HBV)-related liver cirrhosis (LC), 107 patients with HBV-related HCC, and 105 healthy controls. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) strategy and polymerase chain reaction-sequence specific primer (PCR-SSP) strategy were used to detect IL27 gene -964A/G and 2905T/G polymorphisms, respectively. DNA sequencing was used to validate genotype results. RESULTS There were no significant differences in the genotype and allele frequencies of IL27 gene polymorphisms between the groups of patients and healthy controls. Furthermore, no association was found between the distributions of the haplotypes and HCC risk. CONCLUSION These findings indicate that the genetic variants in IL27 gene may not contribute to HCC development. Further studies with large sample size should be conducted to validate this association.

Association of COMT Val158Met polymorphism and breast cancer risk: an updated meta-analysis.

BackgroundCatechol-O-methyltransferase (COMT) is one of the most important enzymes involved in estrogen metabolism and its functional genetic polymorphisms may be associated with breast cancer (BC) risk. Many epidemiological studies have been conducted to explore the association between the COMT Val158Met polymorphism and breast cancer risk. However, the results remain inconclusive. In order to derive a more precise estimation of this relationship, a large meta-analysis was performed in this study.MethodsSystematic searches of the PubMed, Embase and Cochrane Library were performed. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to estimate the strength of the association.ResultsA total of 56 studies including 34,358 breast cancer cases and 45,429 controls were included. Overall, no significant associations between the COMT Val158Met polymorphism and breast cancer risk were found for LL versus HH, HL versus HH, LL versus HL, recessive model LL versus HL+HH, and dominant model LL+HL versus HH. In subgroup analysis by ethnicity, source of controls, and menopausal status, there was still no significant association detected in any of the genetic models.ConclusionOur meta-analysis results suggest that the COMT Val158Met polymorphism may not contribute to breast cancer susceptibility.Virtual slidesThe virtual slides(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs4806123577708417

The antiatherogenic effects of components isolated from pollen Typhae

Based on the results of previous investigations that pollen Typhae, a Traditional Chinese Medicine, Had antiatherogenic effects, several components were isolated successively from the drug and their effects on porcine aortic endothelial cell (EC) and smooth muscle cell (SMC) cultures as well as on platelet aggregation were examined. 12 components isolated from Pollen Typhae have been identified on their chemical structures and biological effects. 4 of them showed different evident antiatherogenic effects. 1) Isorhamnetin-3-O-rhamnosyl-glucoside could stimulate EC to produce tPA and PGI2; 2) Quercetin-3-O-neohesperidose could protect EC from injury by fibrin, as well as raise tPA activity; 3) beta-Sitosterol palmitate could inhibit SMC proliferation and 4) beta-Sitosterol glucoside showed an inhibitory effect on platelet aggregation. These results would provide some information for the search of new drugs in the treatment and prevention of atherosclerosis.