ABSTRACT
Objective@#To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.@*Methods@#From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.@*Results@#All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion.@*Conclusion@#Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
ABSTRACT
Objective To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.Methods From January 2015 to January 2019,16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery,The Second Affiliated Hospital to Inner Mongolia Medical University.They were 14 men and 2 women with a mean age of 38.4 years (range,from 20 to 55 years).All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy.The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.Results All patients were followed up for a mean time of 12.6 months (range,from 6 to 30 months).The mean operation time was 68.4 minutes (range,from 52 to 96 minutes);the mean amount of hemorrhage during operation was 96.8 mL (range,from 48 to 122 mL);the mean period of bone union was 4.8 months (range,from 3 to 8 months).The postoperative mean AOFAS score was 75.3 points (range,from 43 to 91 points).Complications occurred in 4 cases,including one case of talus ischemic necrosis,one case of partial talus ischemic necrosis accompanied by tibial arthritis,one case of subtalar arthritis,and one case of combined tibial,talar and subtalar arthritis.All incisions obtained primary healing,with no complications like infection,screw breakage,delayed union or nonunion.Conclusion Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
ABSTRACT
BACKGROUND:Tissue-engineered tendons have been used to repair the damaged tendon tissue. Use of tissue-engineered tendons for repair of tendon injury has become a hot spot in this research field. OBJECTIVE: To elaborate the types, advantages and disadvantages of seed cels, the design method, advantages and disadvantages of scaffold materials, and the factors that induced the formation of tendon, so as to promote the optimization of each joint, al of which benefit for mature construction of tissue-engineered tendons. METHODS: The related reviews and paper reports of tendon tissue engineering published from January 2000 to January 2015 were retrieved from Chinese Biomedical Literature Database (CBM), China Knowledge Resources Database (CNKI) series database, Chinese Citation Database and PubMed database. The key words were “tissue engineering; tendon; tendon defect”. The research progress of seed cels, scaffold material and induction factors were analyzed. RESULTS AND COMCLUSION:The recent research of tissue-engineered tendons for repair of tendon injury has been summarized. Seed cels, scaffold, induction factors were discussed. Tendon stem cels, as a kind of seed cels, are currently the first choice in the process of tissue engineering tendon research, because tendon stem cels have the homology of the homogenous or autologous tendons and possess strong differentiation and proliferation capacities. However, there have been no systematic schemes regarding acquisition and proliferation and culture of tendon stem cels. The currently designed tissue-engineered tendons cannot meet the clinical requirements because of poor mechanical properties of tendon tissue, poor integration with the host tissue, being susceptible to degradation in late period and functional disuse. Induction factors are the laft key factors for tissue-engineered tendons for repair of tendon injury. The selection and use of induction factors are prerequisites for the regulation of tendon tissue development. But the categories of induction factors and the association and interrelationship between induction factors have not been fuly clear and studies are needed to further investigate these uncertainties.
ABSTRACT
BACKGROUND:As mechanical load-bearing tissues, tendons have unique biomechanical characteristics. Mechanical loading is necessary in tendon development, and the tendon can alter its structure and biological behaviors in response to the various mechanical loading conditions. OBJECTIVE: To fuly understand the healing process and biomechanical properties of the damaged tendon so as to know the researching progress in the role of stress in the tendon healing process. METHODS: An electronic search of Chinese Biomedical Literature Database and PubMed databases was done for colection of reviews and papers addressing stress effects on tendon healing, and then we analyzed the role of stress in the healing process of tendon from the micro and macro levels. RESULTS AND CONCLUSION:Totaly 59 relevant articles were enroled. Tendon is sensitive to stress, and it can change its structure and biological reaction in response to different stress loadings. Proper stress stimulus to the tendon is necessary to the tendon development and healing. How to achieve a good balance between the lowest (resulting in alienation effect) and the highest stress loadings (resulting in minimaly invasive injury) during the clinical tendon healing is a chalenge. At present the treatment of tendon injuries is stil a huge chalenge to clinicians, and the vast majority of tendon injuries belong to tissue healing.
ABSTRACT
BACKGROUND:The therapeutic effectiveness on tendon injury is closely related to the material of tendon suture. OBJECTIVE: To review the progress of tendon suture materials and tendon biomechnics in recent years. METHODS:A computer-based search of CNKI (January 1999 to December 2014), and PubMed (January 1950 to December 2014) was performed for relevant articles using the keywords of “tendon, suture materials, biomechanics” in Chinese and English, respectively. RESULTS AND CONCLUSION:Ideal tendon repair refers to the restoration of the continuity of its anatomical structure, tensile strength and sliding function in physiology, which is influenced by many factors. Suture technique and choice of suture materials are two steps that cannot be ignored. With the development of surgical tendon suture technique, in order to improve the quality of tendon healing, ideal tendon suture is first to have sufficient strength to avoid an early tensile fracture; secondly, the elasticity cannot be too large that can cause a gap between suturing ends and affect tendon healing, and time for protecting the tendon strength is as long as possible. Therefore, the optimal choice of tendon suture materials should be based on suture methods and biomechanical characteristics of suture lines, thereby to promote tendon healing.
ABSTRACT
Objective To evaluate the role of inositol triphosphate receptor (IP3 R) in the fractalkine-induced activation of p38MAPK signaling pathway in BV-2 microglial cells.Methods BV-2 microglial cells were seeded in 3.5 cm diameter dishes (5 ml/dish),50 ml culture flasks (8 ml/flask) or 24-well plates (1 ml/hole) with a density of 1 × 105/ml and randomly divided into 5 groups (n =25 each) ∶ control group (group C),fractalkinegroup (group F),CX3C chemokine receptor 1 (CX3CR1) antibody anti-CX3CR1 + fractalkine group (group CF),IP3R antagonist 2-APB + fractalkine group (group AF) and p38 mitogen-activated protease (p38MAPK) inhibitor SB203580 + fractalkine group (group SF).Fractalkine 10 nmol/L was added to the culture medium in groups F,CF,AF and SF.The anti-CX3CR1 15 μmol/L,2-APB 50 μmol/L and SB203580 10 μmol/L were added to the culture medium in groups CF,AF and SF,respectively,1 h before addition of fractalkine.The cells were then cultured for 24 h.The intracellular Ca2+ concentration ([Ca2+]i) was measured during the 10 min incubation with fractalkine.The phosphorylation of p38MAPK was measured at 0,30,60,120 and 240 min of incubation with fractalkine.The concentrations of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in theculture medium were determined at 24 h of incubation with fractalkine.Results Compared with group C,[Ca2+]i,and the phosphorylation of p38MAPK and concentrations of IL-1β and TNF-α were significantly increased in groups F,CF,AF and SF (P ＜ 0.05).[Ca2+]i was significant lower in groups AF and CF and phosphorylation of p38MAPK and concentrations of IL-1β and TNF-α were significantly lower in groups CF,AF and SF than in group F (P ＜ 0.05).Conclusion IP3 R is involve in the fractalkine-induced activation of p38MAPK signaling pathway in BV-2 microglial cells.
ABSTRACT
Objective To determine whether p38 mitogen-activated protein kinase (p38MAPK) signaling pathway is involved in cerebral fractalkine-induced hyperalgesia in mice.Methods Two hundred and twenty-five male Kunming mice weighing 30-40 g were randomly divided into 4 groups:group control ( group C,n =55 ) ;group fractalkine (group F,n =60); group anti-CX3CR1 + fractalkine (group CF,n =55) and group SB203580 (p38MAPK inhibitor) + fractalkine (group SF,n =55).Fractalkine 100 ng was injected into cerebral lateral ventricle (i.c.v.) in groups F,CF and SF.Anti-CX3CR1 1 μg and SB203580 1 μg were injected i.c.v.at 1 h before fractalkine injection in groups CF and SF respectively.Paw withdrawal latency to a thermal nociceptive stimulus (PWL) was measured at 30 min before the drugs were injected into cerebral lateral ventricle and 30,60,120 and 240 min after fractalkine injection.Five animals were sacrificed after PWL measurement at each time point and their brains were removed for determination of phosphorylated p38MAPK protein expression (by Western blot analysis).Five animals were sacrificed at 30 min before the drugs were injected into cerebral lateral ventricle and 6,12 and 24 h after fractalkine injection for determination of IL-1β and TNF-α contents in the brain (by ELISA) in all the 4 groups.In group F 5 animals were sacrificed at 4 h after fractalkine injection for determination of action of fractalkine on microglia or astrocyte (by immunofluorescence).Results Fractalkine i.c.v.injection significantly reduced PWL and increased phosphorylated 38MAPK,IL-1β and TNF-α levels in group F as compared with group C.Pretreatment with anti-CX3CR1 or SB203580 significantly decreased fractalkine-induced hyperalgesia and phosphorylated-p38MAPK,IL-1β and TNF-α levels in groups CF and SF as compared with group F.Fractalkine was localized at microglia.Conclusion p38MAPK signal transduction pathway is involved in cerebral fractalkine-induced hyperalgesia in mice.
ABSTRACT
BACKGROUND: The problems such as fast drug degradation, great drug loss and poor barrier effect exist when using liquid molecular biomaterial as barriers in preventing tendon adhesion. Accordingly, it has aroused increasing attention to seek for membrane biomaterials as barriers. Simultaneously, it found that tendon cells would proliferate and differentiate under controls of multiple endogenous growth factors that promote tendon endogenous healing. However, it is poorly understood which the specificity factor for tendon healing is. OBJECTIVE: To study effect of epidermal growth factor (EGF) combined with degradable collagen membrane on preventing tendon adhesion and improving tendon endogenous healing. METHODS: Thirty ten-month old leghorn cocks were randomly divided into 3 groups, with 10 animals in each group. The third toe of left foot of each animal was prepared for avulsion model, and sutured with improved Kessler method. The broken ends were encapsulated with EGF combined with degradable collagen membrane (combination group), degradable membrane alone (collagen membrane group) or without treatment (blank control group). Four weeks later, the specimens were evaluated by gross observation, biomechanical test, light microscope and electron microscope. RESULTS AND CONCLUSION: In the combination group, there were a large amount of type Ⅰ collagen inside the sutured tendon, they were closely and lined up in order. The amount of collagen-fibronectin was less and the adhesion obviously was less than the control group. The tendon cells were matured. The adhesion in the collagen membrane group was slightly, there were a large amount of type Ⅲ collagen inside the sutured tendon, which loosely but well organized. In the blank control group, type Ⅰ and Ⅲ collagen arranged crisscrossed, with heavy adhesion. The results suggest that EGF can promote tendon endogenous healing and degradable collagen membrane can prevent tendon exogenous healing, thus, prevent the formation of adhesion.