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OBJECTIVE@#Digital therapy is important in treating motor system disease. The outcome of digital therapy in post-operative rehabilitation of knee anterior cruciate ligament (ACL) reconstruction is assessed.@*METHODS@#142 patients are treated with digital rehabilitation therapy after ACL reconstruction. Patients' pain score, joint motion, lower limb function score, anxiety score are statistically analyzed. Patients' satisfaction, device usage and adverse events are documented.@*RESULTS@#At post-operative 1st day, 8th weeks, 12th weeks, pain score are 4, 2, 1, knee joint range of motion are 55°, 110°, 143°, lower limb function score are 18, 56, 76, anxiety score are 32.5, 26, 23.5 respectively. Patients' satisfaction are 9.4. Mean duration of device usage is (177.6±38.0) minutes per week. Rehabilitation-related and device-related adverse event does not happen.@*CONCLUSIONS@#Digital therapy promotes post-operative rehabilitation after ACL reconstruction.
Subject(s)
Humans , Knee Joint , Lower Extremity , Medicine , Anterior Cruciate Ligament Reconstruction , PainABSTRACT
BACKGROUND: NKX2-5 is an important transcriptional regulator during mammalian heart development. Studies from model animals such as rats, mice, and zebrafish have shown that the absence or abnormal function of NKX2-5 affects heart development, leading to pathological manifestations similar to human congenital heart disease. However, the regulatory role and specific mechanisms of NKX2-5 in cardiac development are still unclear. OBJECTIVE: To review the molecular structure, functional effects, and upstream and downstream regulatory molecules of NKX2-5. METHODS: The search terms “NKX2-5, congenital heart disease, CHD, heart development” were used for literature retrieval in the PubMed database (website https://www.ncbi.nlm.nih.gov/pubmed/). The deadline for publication was April 1, 2019. By downloading and reading the retrieved literature, articles irrelevant to NKX2-5 and with duplicate opinions and similar conclusions were excluded. Finally 97 eligible articles were taken for review. RESULTS AND CONCLUSION: (1) NKX2-5 plays a key role in the regulation of cardiac development. Abnormal functions or gene mutations of NKX2-5 can lead to abnormal cardiac development and dysfunction, which are closely related to the occurrence of human congenital heart disease. (2) The function of NKX2-5 depends on its functional domains. NKX2-5 enters the nucleus after transcription and translation, and activates or inhibits downstream regulatory molecules through binding with CO-factors or alone to specific DNA sequences, thereby regulating the proliferation, migration, differentiation and function of cardiac precursor cells and regulating the correct cardiac development process and the normal development and function of the cardiac conduction system. (3) The transcription, translation, nucleation process, transcription activation or inhibition of NKX2-5 is also regulated by various methods. These regulatory factors regulate NKX2-5 from the aspects of chromatin conformation, promoter and enhancer functions, RNA uncoiling, post-transcriptional modification, and nuclear localization.
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Objective@#To evaluate osteotomy, bone shortening and lengthening by one stage with external fixation for a large bone defect following open femoral fracture.@*Methods@#From April 2014 to April 2019, 11 consecutive patients with a large bone defect following open femoral fracture were treated at Department of Orthopaedics, The Sixth People’s Hospital of Shanghai. They were 9 males and 2 females, with an average age of 40.5 years (from 18 to 70 years). The left side was involved in 6 cases and the right side in 5. All their primary open fractures had deteriorated into osteomyelitis and bone defects after treatment. Their bone defects averaged 60.5 mm after thorough debridement. Postoperative X-ray examinations were taken regularly. Bony union time and index, time till removal of external fixator, external fixation index, flap survival, soft tissue healing, visual analogue scale (VAS), Association for Studying and Application of Methods of Ilizarov (ASAMI) scores for bone healing and lower limb function were recorded.@*Results@#All the patients were followed up for 9 to 30 months (mean, 21.9 months). The bony union time averaged 10.5 months (from 5.2 to 22.3 months). The bony union indexes averaged 52.9 d/cm (from 33.4 to 73.3 d/cm). The time till removal of external fixator averaged 15.5 months (from 9.8 to 27.5 months). The external fixation indexes averaged 86.0 d/cm (from 60 to 113 d/cm). All the bone nonunions healed with no recurrence of osteomyelitis. Complications like union failure, refracture at ends of bone lengthening or fracture, or leg length discrepancy>2.5 cm, happened in none. The VAS scores ranged from 0 to 3 points. By ASAMI evaluation, the bony union was excellent in 10 cases and good in one case, and the lower limb function was excellent in 3 cases, good in 7 cases and fair in one.@*Conclusion@#Osteotomy, bone shortening and lengthening by one stage with external fixation is a reliable treatment for large femoral bone defects because this strategy can remove the lesions and restore the femoral length at the same time.
ABSTRACT
Objective To evaluate osteotomy,bone shortening and lengthening by one stage with external fixation for a large bone defect following open femoral fracture.Methods From April 2014 to April 2019,11 consecutive patients with a large bone defect following open femoral fracture were treated at Department of Orthopaedics,The Sixth People's Hospital of Shanghai.They were 9 males and 2 females,with an average age of 40.5 years (from 18 to 70 years).The left side was involved in 6 cases and the right side in 5.All their primary open fractures had deteriorated into osteomyelitis and bone defects after treatment.Their bone defects averaged 60.5 mm after thorough debridement.Postoperative X-ray examinations were taken regularly.Bony union time and index,time till removal of external fixator,external fixation index,flap survival,soft tissue healing,visual analogue scale (VAS),Association for Studying and Application of Methods of Ilizarov (ASAMI) scores for bone healing and lower limb function were recorded.Results All the patients were followed up for 9 to 30 months (mean,21.9 months).The bony union time averaged 10.5 months (from 5.2 to 22.3 months).The bony union indexes averaged 52.9 d/cm (from 33.4 to 73.3 d/cm).The time till removal of external fixator averaged 15.5 months (from 9.8 to 27.5 months).The external fixation indexes averaged 86.0 d/cm (from 60 to 113 d/cm).All the bone nonunions healed with no recurrence of osteomyelitis.Complications like union failure,refracture at ends of bone lengthening or fracture,or leg length discrepancy ＞ 2.5 cm,happened in none.The VAS scores ranged from 0 to 3 points.By ASAMI evaluation,the bony union was excellent in 10 cases and good in one case,and the lower limb function was excellent in 3 cases,good in 7 cases and fair in one.Conclusion Osteotomy,bone shortening and lengthening by one stage with external fixation is a reliable treatment for large femoral bone defects because this strategy can remove the lesions and restore the femoral length at the same time.