Clinical analysis of external micro-locking plate in the treatment of fifth metatarsal comminuted fractures / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy of external micro-locking plate combined with closed reduction in the treatment of fifth metatarsal comminuted fracture with severe soft tissue injury.@*METHODS@#From January 2018 to December 2019, 13 patients received micro-locking plate combined with closed reduction treatment due to the fifth metatarsal comminuted fracture with severe soft tissue injury. There were 11 males and 2 females patients, ranging in age from 21 to 69 years. According to the fracture AO fracture classification, 9 cases belonged to type 87(S)-C2.2 and 4 cases belonged to type 87(S)-C2.1. The fifth metatarsal cuneiform articular surface was not involved, and all of them were comminuted fractures of the fifth metatarsal shaft. All soft tissues were damaged to varying degrees. Three patients got small defect of skin and soft tissue, and they were treated with debridement and suture after one-stage emergency surgery. The fracture healing and complications were observed, and the clinical efficacy was evaluated according to the midfoot function score of American Orthopaedic Foot & Ankle Society (AOFAS) at the latest follow-up.@*RESULTS@#All patients were followed up, and the duration ranged from 3 to 12 months. One patient had delayed union. One patient had local skin necrosis and was treated with second-stage skin grafting to repair the wound surface. No external screw breakage or infection was reported, the skin soft tissue healed satisfactorily and reached bony union, with the union time ranging from 8 to 19 weeks. The postoperative functional recovery was rated according to the midfoot score of AOFAS, the score ranged from 49 to 98, and 7 patients got an excellent result, 4 good, 1 fair and 1 poor.@*CONCLUSION@#The external micro-locking plate combined with closed reduction in the treatment of fifth metatarsal comminuted fracture with severe soft tissue injury has the advantages of simple operation, good stability and low infection rate, which is helpful to the repair of soft issue injury, and the fixation can be removed early in outpatient clinic. To sum up, this surgical procedure is suitable for patients with severe soft tissue injury and comminuted fracture to avoid periosteum stripping. The space occupying is smaller than the micro-external fixator, which is convenient for patients with early functional exercise.

Micro-locking plate external fixation for the treatment of proximal phalanx comminuted fractures / 中国骨伤

OBJECTIVE@#To explore clinical efficacy of external placement of micro-locking plate combined with small incision reduction in treating proximal phalanx comminuted fractures.@*METHODS@#From January 2018 to December 2019, 17 patients with proximal phalanx comminuted fractures were treated with micro-locking plate combined with small incision open reduction, including 13 males and 4 females, aged from 16 to 64 years old with an average of (37.2±20.1) years old. Two patients were accompanied by soft tissue extrusion and opening injuries, which were treated with fixed treatment after the first-stage emergency debridement. Curative effect was evaluated according to total active flexion scale (TAFS) of American Hand Surgery Association at 6 months after operation;and fracture healing, nailing, local soft tissue healing, complications were observed.@*RESULTS@#All patients were followed up from 6 to 12 months with an avaerge of(9.3±3.6) months. Two patients occurred delayed union, 1 occurred local skin necrosis and was treated with the second-stage skin grafting to repair wound surface. No external screw breakage or infection was reported, skin soft tissue healed favorably and reached bony union, the union time from 12 to 24 weeks with an average of (15.7±2.1) weeks. According to TAFS standard, 9 patients got excellent result, 5 good and 3 poor at 6 months after operation.@*CONCLUSION@#External micro-locking plate combined with small incision reduction in treating proximal phalanx comminuted fracture, which has advantages of good condition of skin and soft tissue, simple operation, early functional exercise, good range of motion of interphalanx joint, and function score of recovery period is high.

Potential targets of Euodiae Fructus in treatment of insomnia based on network pharmacology / 中国中药杂志

The acupoint application of Euodiae Fructus at Yongquan(KI1) can significantly improve the sleep quality of patients with insomnia with berberine as the main effective component for the efficacy. Nineteen active compounds and 203 drug targets were screened out from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). After comparison with GeneCards and Online Mendelian Inheritance in Man(OMIM), 24 common genes of diseases and drugs were obtained. STRING 11.0 was used to construct a protein-protein interaction(PPI) network of the overlapping genes, and Matthews correlation coefficient(MCC) was employed to screen the core genes, which were then subjected to enrichment analysis with gene ontology(GO) and Kyoto encyclopedia of genes and genomes(KEGG). The results revealed that the main compounds of Euodiae Fructus, such as berberine and rutaecarpine, participated in the biological processes(such as neurotransmitter receptor activity) by regulating C-reactive protein(CRP), estrogen receptor 1(ESR1), 5-hydroxytryptamine(5-HT) receptor, and interleukin-6(IL-6) to exert sedative, anxiolytic, and antidepressant effects. Sixty 4-week-old SPF mice were randomly divided into a control group, a model group, a positive drug(diazepam tablets) group, and low-, medium-, and high-dose berberine groups. Medication with corresponding drugs was performed for one week. The results demonstrated that berberine was potent in reducing the activities and standing times of mice, down-regulating the levels of CRP and IL-6 mRNA in the hypothalamus, and up-regulating the expression of 5-HT(P<0.01); however, no significant effect on ESR1 was observed. The network of Euodiae Fructus in treating insomnia was constructed by network pharmacology and verified by tests. The findings indicated that the therapeutic efficacy of Euodiae Fructus in treating insomnia was achieved by participating in multiple biological processes, such as neurotransmitter receptor activity, which provided a scientific basis for its clinical application.

Different mini skin flaps in repairing finger soft tissue with bone defect / 中国骨伤

OBJECTIVE@#To explore surgical methods and clinical effects of three different types of mini skin flap transplantation for repairing finger soft tissue with bone defect.@*METHODS@#Thirty-three patients with finger soft tissue or bone defect were treated from December 2014 to October 2016, including 24 males and 9 females aged from 21 to 52 years old with an average of (36.42±5.70) years old, and soft tissue defect area ranged from 1.3 cm×1.8 cm to 2.3 cm×4.2 cm. According to damage degree, nature and patients' options, 15 finger of 15 cases were adopted retrograde dorsal metacarpal artery perforators fascia flap, 10 fingers of 9 cases were treated with free foot artery descending branch wrist skin flap, 9 fingers of 9 cases were treated with free the second toe details phalanges compound flap. Survival rate, postoperative complications and finger function assessed by Dargan functional criteria at the latest follow up were observed.@*RESULTS@#All flaps were survived, both of donor site and recipient site were without deep infected. The donor site of one patient occurred necrotic, and the distal donor site of one patient occurred surface necrotic, then healed by active dressing change. All patients were followed up from 6 to 16 months with an average of(8.34±1.28) months. Two points of finger recognition were restored between 8 and 12 mm with an average of (8.84±0.43) mm, and the appearance, texture and sensory functions of skin flap were restored. No obvious complications were observed on the donor site. According to Dargan function evaluation of finger joints, 18 patients got excellent results, 14 moderate and 1 good.@*CONCLUSIONS@#Three kinds of mini skin flap could receive good results in repairing soft tissue of finger or bone defect. Reverse dorsal metacarpal artery perforator fascia flap is not necessary with anastomosing blood vessels and has advantages of safe, simple and high survival rate. Descending branch of superior cutaneous branch of free ulnar artery could cut multiple other perforator flaps simultaneously, and the scar is small and hidden. Dissociated the second toe combined metatarsal phalangeal flap could repair shape and function of finger to the maximum extent and donor site is hidden.

Three-step sequential method for limb skin and soft tissue defect combined with bone or tendon exposed wound / 中国骨伤

OBJECTIVE@#To explore clinical effect of VSD technology, coverage of artificial dermis and autograft for the treatment of limb skin soft tissue defect combined with bone or tendon exposed wound.@*METHODS@#Eighteen patients suffered from limb skin soft tissue defect combined with bone or tendon exposed wound treated by three-step sequential method from January 2013 to June 2015. Among them, including 13 males and 5 females aged from 23 to 72 years old with an average of 34.6 years old; the time from injury to operation ranged from 1.5 to 5.0 hours with an average of 2.5 h. The area of skin and soft tissue injury ranged from 4.2 cm×3.1 cm to 7.4 cm×5.2 cm. Wound recovery and taken skin wound recovery were observed to evaluate clinical results.@*RESULTS@#All patients were followed up from 5 to 16 months, with an average of 7.6 months. Deep bone tendon tissue of wounds were effectively recovered, artificial dermis survived, and quality of healed wound was tough and shape was good. Wound transplant flap was survived, no obvious scar tissue formation, appearance was flat, skin color was a little deeper than normal skin, the overall effect was satisfactory.@*CONCLUSIONS@#Three-step sequential method has good curative effect for patients suffered from limb skin soft tissue defect with bone or tendon exposed wound and refused to repair the flap, and has advantage of simple operation, operation risk, less invasive.

Application of drilling columnar autogenous iliac bone graft and clinical analysis of postoperative complications in the donor bone region / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effect of drilling columnar autogenous iliac bone graft and analyze the effect of bone grafting on postoperative complications in donor site.</p><p><b>METHODS</b>From March 2014 to October 2016, 68 patients with autogenous iliac bone graft were retrospectively analyzed, and divided into drilling group and osteotomy group, 34 patients in each group. In drilling group, there were 24 males and 10 females with an average age of (40.06±5.60) years old ranging from 23 to 53 years old;in osteotomy group, there were 26 males and 18 females with an average age of (39.32±6.44) ranging from 22 to 56 years old. The operative time of bone extraction, blood loss in donor area, healing time of donor site and postoperative donor site complications were observed and compared between the two groups. VAS score was used to evaluate the pain of donor site in different periods after operation.</p><p><b>RESULTS</b>All patients were followed up for 12 to 24 months, with an average of 16.9 months in drilling group and 17.1 months in osteotomy groups. The bone healing structure was displayed in the recipient area in two groups, the effect of autogenous iliac bone grafting was good. There was no significant difference in operative time between two groups (>0.05). There was significant difference between two groups in the amount of donor site bleeding and the time of donor site wound healing(<0.05). Postoperative complications(iliac depression and numbness) were significantly different between two groups (<0.05). There was no significant difference in VAS score between two groups at 2 weeks after operation(>0.05). VAS scores of drilling group at 6 months and 1 year after operation were lower than those of osteotomy group (1.85±0.61 vs 2.97±0.67, 0.000; 1.15±0.56 vs 2.41±0.61, 0.000).</p><p><b>CONCLUSIONS</b>When bone graft is no need to have large pieces of special shape or more cortical bone iliac, it is simple to operate and less complications postoperative by drilling type columnar autogenous iliac bone graft. What's more, it has the obvious advantages of promote healing, improve patient quality of life compared with traditional osteotomy.</p>

Effects of preparation technologies and entrapment materials on encapsulation efficiencies of three constituents' liposomes / 中成药

AIM To prepare the liposomes loaded with celastrol,tanshinone Ⅱ A and tanshinone Ⅱ A sodium sulfonate and to evaluate the effects of preparation technologies and entrapment materials on the encapsulation efficiencies.METHODS The liposomes for three constituents were prepared by film dispersion method and reverse phase evaporation method,respectively.50％ Lecithin high potency,80％ egg yolk lecithin,92％ lecithin high potency and complex phospholipid (5 ∶ 1 for ratio of dipalmitoyl phosphatidylcholine to 50％ lecithin high potency) were served as entrapment materials.The encapsulation efficiencies were thus calculated based on the measured ean sizes and polydispersity of the liposomes.RESULTS Celastrol and tanshinone Ⅱ A sodium sulfonate liposomes accomplished by reverse phase evaporation method got the highest encapsulation efficiency when entrapped with 80％ egg yolk lecithin and 92％ lecithin high potency,respectively,which were higher than those prepared by film dispersion method.And celastrol liposomes exhibited an even superior performance than tanshinone Ⅱ A sodium sulfonate liposomes.Tanshinone Ⅱ A lipisome prepared by film dispersion method and then entrapped with 50％ lecithin high potency obtained its the highest value of encapsulation efficiency,which was much lower than those of another two liposomes.CONCLUSION Reverse phase evaporation method is appropriate for hydrophobic celastrol with multiple hydrogen bonds and hydrophilic sodium tanshinone Ⅱ A without hydrogen bonds to prepare their liposomes,while film dispersion method is applicable to hydrophobic tanshinone Ⅱ A without hydrogen bonds.

The precise cardiopulmonary resuscitation of cardiopulmonary arrest due to war trauma / 解放军医学杂志

This paper ventures to suggest different cardiopulmonary resuscitation (CPR) technique for cardiopulmonary arrest due to different was injuries. The present paper ventures to present precise cardiopulmonary resuscitation procedure specific to was injuries of different sites and its termination time based on the principle of "individualize treatments according to the injured person and specific situations" in order to reduce the mortality of cardiopulmonary arrest for combat victims.

Minor external fixator for open comminuted phalangeal fractures with non-transarticular / 中国骨伤

<p><b>OBJECTIVE</b>To explore therapeutic effects of minor external fixator for open comminuted phalangeal fractures with non-transarticular.</p><p><b>METHODS</b>From January 2013 to December 2014,13 patients with open comminuted phalangeal fractures were treated by minor external fixator with non-transarticular, including 9 males and 4 females aged from 18 to 56 years old with an average of 35 years old. According to Gustilo classification, 8 cases were type II, and 5 cases were type III. The time from injury to operation ranged from 2 to 7 h averaged 5 h. Seven patients were diagnosed as phalangeal fracture, 6 patients were involved with joint surface of phalangeal, which 1 case combined with inherent nerve damage and 1 case combined with soft tissue defect repaired at stage II. The patients were fixed by plaster for 2 weeks and removal external fixtor from 6 to 8 weeks after operation and received functional exercise.</p><p><b>RESULTS</b>All patients were followed up from 3 to 12 months with an average of 7 months. One case occurred metacarpophalangeal joints stiffness. No screw breakage, inflammation occurred. Skin soft tissue recovered well and obtained bone healing, the average time of bone healing was (4.6 ± 1.0) weeks. According to TAM scoring system used by Hand Surery Association of Chinese Medical Association, 7 cases got excellent results, 4 good, 1 moderate and 1 poor.</p><p><b>CONCLUSION</b>Minor external fixator for open comminuted phalangeal fractures with non-transarticular has advantages of simple operation, good stability, and could adjust at the later stage, less damage for soft tissue periosteum, low inflammatory rate, earlier functional exercise. It is worth to be popularized and applied.</p>

Initiation of the "abdominal pump" research of cardiopulmonary resuscitation by increasing intraabdominal pressure / 解放军医学杂志

As there are contra-indications for chest compression for cardiopulmonary resuscitation (CPR), and strong chest compression may produce fracture of ribs, and also the occurrence of imbalance between ventilation and perfusion, we explored the effect of abdominal compression for CPR after cardiac arrest. Our previous research conducted in animals, and also in several clinical cases indicated that better circulatory and respiratory support effects and a higher survival rate could be achieved with CPR based on increasing intra-abdominal pressure. To study the mechanism of "abdominal pump" to achieve cardiopulmonary and cerebral resuscitation, the author has studied the anatomical physiological features of abdominal compression, and proposed the mechanism of "abdominal pump" for CPR. It provides highly theoretical guidance and practical value to the "abdominal pump" for CPR. It’s our impression that abdominal compression is as important as chest compression in CPR, and it might prevent complications of chest compression with high success rate.

Effects of subdiaphragmatic cardiac compression on cardiac arrest during liver transplantation / 中华医学杂志(英文版)

Cardiac arrest during upper abdominal surgery such as liver transplantation is a rare but very severe complication. Traditional external cardiac compression has been the mainstay of basic life support in general circumstances. Subdiaphragmatic cardiac compression (SDCC), with no incision in the diaphragm, may be a more effective measure. This maneuver can provide more effective and timely cardiac compression via the already open abdomen in surgery and not add extra trauma. This method can provide a quicker and more effective means of circulation support for intraoperative cardiac arrest patients without adding new injuries. Five cases are reported and all the patients had return of spontaneous circulation (ROSC). This is the first report of the SDCC method.

Involvement of Caspase-3 and p38 mitogen-activated protein kinase in MMT-induced apoptosis in PC-3M cells / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the function of Caspase-3 and p38 MAPK in MMT-induced apoptosis in PC-3M cells.</p><p><b>METHODS</b>After incubation of PC-3M cells with 1 mmol/L MMT, the activity of Caspase-3 was examined. The influence on cells viability of Z-DEVD-FMK, a Caspase-3-specific peptide inhibitor, was also examined. Western blot was used to examine the change of p38 MAPK. The effect on cells viability and Caspase-3 activity of SB203580, a specific inhibitor of p38 MAPK, were also examined.</p><p><b>RESULTS</b>The activity of Caspase-3 increased significantly in MMT-induced apoptosis in PC-3M cells /9P < 0.01), and Z-DEVD-FMK could protect cells from apoptosis (P < 0.01). In this course, the phosphorylation of p38 MAPK could be observed. SB203580 inhibited Caspase-3 activity (P < 0.05) and prevented PC-3M cells from MMT-induced apoptosis (P < 0.05).</p><p><b>CONCLUSION</b>Caspase-3 and p38 MAPK are involved in MMT-induced PC-3M cells apoptosis.</p>

Protective effects of hydroxyethylpuerarin against brain astrocytes injury induced by hydrogen peroxide / 药学学报

<p><b>AIM</b>To study the protective effects of hydroxyethylpuerarin against the injury of astrocytes induced by hydrogen peroxide (H2O2).</p><p><b>METHODS</b>Experiments were performed with cells from passage 4. Plasma membrane integrity was measured by lactate dehydrogenase (LDH) release. The occurrence of apoptosis was measured by flow cytometry. The glutamate uptake of astrocytes was studied with [3H]-glutamate incorporation. Intracellular superoxide dismutase (SOD) activity and malondialdehyde (MDA) level were assessed by automatic biochemistry analyzer.</p><p><b>RESULTS</b>Compared with H2O2 injured group, the occurrence of apoptosis, levels of LDH release and intracellular MDA of astrocytes reduced in hydroxyethylpuerarin pre-treated groups, but the glutamate uptake and intracellular SOD activity of astrocytes increased.</p><p><b>CONCLUSION</b>Hydroxyethylpuerarin could reduce the occurrence of apoptosis and improve neurotrophic function of astrocytes, which may be related with its antioxidant effects during oxidative stress.</p>

Mechanism of reactive oxygen species in manganese chloride-induced apoptosis in PC12 cells / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the mechanism of reactive oxygen species (ROS) in manganese chloride (MnCl(2))-induced apoptosis in PC12 cells.</p><p><b>METHODS</b>The model that MnCl(2) induced apoptosis in PC12 cells was established. The apoptotic effect of MnCl(2) on PC12 cells was analyzed with the MTT, the flow cytometry and the DNA fragmentation. The production of ROS and ATP in MnCl(2)-induced apoptosis of PC12 cells was examined. The influence of MnCl(2) on the expression of bcl-xl, bax and the activity of Caspase 3 was also analyzed.</p><p><b>RESULTS</b>MnCl(2) triggered PC12 cells apoptosis in a dose-and time-dependent manner (P < 0.01). The rate of apoptosis was significantly increased (P < 0.01) when MnCl(2) of 2 mmol/L induced PC12 cells for 36 hours. The production of ROS was increased (P < 0.001) and the quantity of ATP was decreased (P < 0.01) in PC12 cells with the same inducement of MnCl(2). The expression of bcl-xl was inhibited and the bax was activated in this process (P < 0.01). Caspase 3 was also activated (P < 0.01).</p><p><b>CONCLUSION</b>MnCl(2) induces apoptosis of PC12 cells, which is related to the increase of ROS, the inhibition of the mitochondria and the activation of Caspase 3.</p>

Effect of xuebijing on T lymphocyte function in patiens with chronic obstructive pulmonary diseases / 中华急诊医学杂志

Objective Toobserve the effect of xuebijing on T lymphocyte function in patiens with acute exacerbation chronic obstructive pulmonary diseases (COPD).Method IL-2 of T lymphocytes in patients with COPD were determined with the method of enzyme-linked immunoadsordent assay kits (ELISA);the activation markers CD25 were analyzed by flow cytomery;proliferation assays of T lymphocytes were determined by MTT assay.Results In COPD patients,IL-2 levels,the activation markers CD25,the proliferation assays were significantly lower than those of normal control group (P