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Objective:To investigate the specific types of lateral meniscus injury in Schatzker type II tibial plateau fractures and its potential correlation with CT features of the lateral plateau.Methods:The data of 213 patients with Schatzker II tibial plateau fractures from August 2014 to June 2021 were retrospectively analyzed, including 132 males and 81 females, aged from 29 to 61 years, with an average of 44.9 years. All patients underwent arthroscopic evaluation of fracture reduction immediately after open reduction and internal fixation (ORIF). According to the actual situation during the operation, the types and locations of lateral meniscus injury were determined and the patients were divided into the meniscus injury group and non-injury group. By measuring lateral plateau depression (LPD) and lateral plateau widening (LPW) of the lateral tibial plateau on CT images, the correlation of which and lateral meniscus injury was analyzed. The optimal critical values of LPD and LPW for predicting lateral meniscus injury were obtained by drawing the relevant receiver operating characteristic (ROC) curves.Results:The meniscus injury group (109 patients) mainly showed injuries involving the mid-body and posterior horn of lateral meniscus (98.2%, 107/109) and LPD was 13.1±3.2 mm; while the LPD of 104 patients without meniscus injury was 9.1±3.0 mm with a statistical difference ( t=3.98, P<0.001). The LPW of meniscus injury group and non-injury groups was 8.0±1.3 mm and 6.7±1.6 mm, respectively, and the difference was statistically significant ( t=2.68, P=0.011). The optimal predictive critical point of LPD and LPW was 7.6 mm (sensitivity 90.3%, specificity 64.7%, area under the curve 0.834) and 7.3 mm (sensitivity 80.5%, specificity 58.8%, area under the curve 0.722). Conclusion:Schatzker II tibial plateau fractures combined with lateral meniscus injury is usually characterized by meniscus-joint capsule separation, rupture and longitudinal fracture. The mid-body and posterior horn of lateral meniscus injury is more likely to occur when LPD> 7.6 mm and/or LPW> 7.3 mm on coronal CT images.
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Objective:To explore the sequence of reduction and fixation in the treatment of middle and lower tibiofibular fractures on the same plane using tibial intramedullary nailing plus fibular plating.Methods:A retrospective analysis was performed of the 58 patients with middle and lower tibiofibular fractures on the same plane from January 2016 to December 2017. They were 38 males and 20 females, aged from 20 to 65 years (average, 40 years). The left side was affected in 30 cases and the right in 28. By the AO classification, 27 cases were type 42-A, 18 ones type 42-B and 13 ones type 42-C. Of them, 33 had the fibula reduced and fixated first (the fibular group) while 25 had the tibia reduced and fixated first (the tibial group). The 2 groups were compared in terms of operation time, rate of tibial closed reduction, rate of dynamization of intramedullary nails, fracture healing time and postoperative complications.Results:All the patients were followed up for 12 to 24 months (average, 17.2 months). The operation time in the fibular group was 96 minutes ± 15 minutes, significantly shorter than that in the tibial group (116 minutes ± 19 minutes)( P<0.05). The rate of tibial closed reduction was 84.8% (28/33) in the fibular group and 60.0%(15/25) in the tibial group, presenting a significant difference ( P<0.05). There were no significant differences between the 2 groups in the rate of dynamization of intramedullary nails, fracture healing time or postoperative complications ( P>0.05). Conclusions:Tibial intramedullary nailing plus fibular plate osteosynthesis is an effective treatment for the middle and lower tibiofibular fractures on the same plane. When the fracture line is not located in the narrow segment of the tibia, reduction and fixation of the fibula first is advantageous over reduction and fixation of the tibia first, because it can facilitate tibial reduction and nail placement and improve surgical efficiency without increasing the fracture healing time.
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Objective To analyze the characteristics of proximal deep vein thrombosis (DVT) after total joint arthroplasty.Methods 40 cases of proximal DVT were collected from May 2007 to October 2016 which were all diagnosed by lower limb venography or sonography.There were 9 males and 31 females aged from 38 to 86 years,average 67 years,and body mass index was from 16.94 to 31.25kg/m2,with an average of 24.3 kg/m2.29 cases of THA patients and 11 cases of TKA patients.The anatomical distribution,size,radiological performance,local physical findings were recorded and multivariable analysis was performed to evaluate the relationship between distribution of proximal DVT and related parameters including age,gender (male/female),side of leg(left/right),surgery type(knee and hip),preoperative diagnosis(femoral neck fracture/other disease),time of diagnosis with DVT (during hospitalization/after discharge).Results Among 40 proximal DVT cases,31 cases diagnosed by phlebography and 9 cases were diagnosed by ultrasound.2 cases were isolated proximal DVT while 38 cases connected with distal DVTs.9 cases of blood clots in the proximal and distal thrombosis connected discontinuously.There was no isolated proximal DVT in TKA group and 10 cases (90.9％) of blood clots in the proximal and distal thrombosis connected continuously while there were 2 cases (6.9％) isolated proximal DVTs in THA group and 21 (77.8％) of blood clots in the proximal and distal thrombosis connected discontinuously,and there was no statistic significant difference between the two groups.The average length of proximal was 8.85±9.3 1cm (range from 2-35cm) with 5.0±2.05 cm in TKA group and 10.31 ± 10.55 cmin THA group.A significant difference was found between the 2 groups (P=0.014).13 cases located in femoral veins and upper venous region which were all from THA group.There was a significant difference in the distribution between surgery type and preoperative diagnosis.However,there was no significant difference between other potential factors and distribution of proximal DVT.25 cases accepted the evaluation of symptom of DVT before scanning.However,no significant difference were found in edema,VAS score,Homans sign,Neuof sign between 9 TKA and 16 THA cases.Conclusion Proximal DVTs after knee and hip arthroplasty are more preferred to connect with distal DVT continuously.Surgery type and preoperative diagnosis have a significant effect on the distribution of proximal DVT.Proximal DVTs in THA and patients with preoperative femoral neck fracture could be more easily involving femoral veins and upper parts.
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BACKGROUND:Bone marrow mesenchymal stem cel s are likely to repair renal injury by differentiating into renal parenchymal cel s. OBJECTIVE:To explore the effect and mechanism of bone marrow mesenchymal stem cel s in the renal repair after mesangial proliferative glomerulonephritis. METHODS:Thirty Sprague-Dawley rats were randomized into normal group, model group and treatment group (n=10 per group). Model group and treatment group were treated with tail vein injection of mouse anti-rat monoclonal antibody Thy1.1 to prepare mesangial proliferative glomerulonephritis models. One week after modeling, rats in the treatment group were given 2×106 bone marrow mesenchymal stem cel s via the tail vein, and rats in the other two groups were given the same volume of normal saline. Two weeks after transplantation, urinary protein, urea nitrogen, creatinine levels were detected;hematoxylin-eosin staining was used for observing pathological changes of the renal tissue under microscope;and the expression of transforming growth factor beta 1 was detected by immunohistochemistry method. RESULTS AND CONCLUSION:The levels of urinary protein, urea nitrogen and creatinine as wel as the expression of transforming growth factor beta 1 in the renal tissue arranged in descending order were listed as fol ows:model group>treatment group>control group, and there were significant differences among three groups (P<0.05). In the model group, diffuse glomerular hyperplasia was observed with the presence of increased extracel ular matrix, partial glomerular sclerosis, and interstitial infiltration of inflammatory cel s;in the treatment group, glomerular hyperplasia, mesangial proliferation and inflammatory cel infiltration were al mitigated compared with the model group. Therefore, bone marrow mesenchymal stem cel transplantation may contribute to renal repair after mesangial proliferative glomerulonephritis, by inhibiting overexpression of transforming growth factor beta 1 in the kidney.
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Objective To evaluate the safety of fibrin sealant (FS) intraperitoneal injection in SD rats .Methods 80 male and female SD rats were randomly divided into four groups (0 ,85.5 ,171 .0 ,342 .0 mg/kg) by body weight .All rats were in-traperitoneally injected with vehicle or FS daily for 14 days followed by a 28-day recovery period .The clinical signs ,hematolog-ical and biochemical indices were measured .The pathology were observed .Results Increase of white blood cell count (WBC) and decrease of fibrinogen (FIB) in d 14 were found in 171 .0 mg/kg and 342 .0 mg/kg dosage groups .Furthermore ,the tend-ency of weight increase of spleen were found in 171 .0 mg/kg and 342 .0 mg/kg dosage groups .Pathological exams of peritoneal cavity found that there were granulation tissues containing FS in some of the rats in 342 .0 mg/kg group .All of these changes got reversed after the recovery period .Conclusion The safety dose in this study is considered to be 85.5 mg/kg ,and the toxic-ity dose is 171 .0 mg/kg .The target toxicity systems or site of FS in SD rats are hematological system ,immune system and in-jection site .The toxic effects of FS are reversible .
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Objective:To investigate the efficacy of warm acupuncture at Biguan(ST 31) in treating post-apoplectic restless legs syndrome. Methods:Fifty patients were randomly divided into treatment and control groups by a waiting control method in order of hospitalization. The treatment group received deep acupuncture at point Biguan(ST 31) plus moxibustion and the control group took L-dopa orally. The curative effects were compared after 28 days' treatment. Results: The total efficacy rate was 76.00% in the treatment group and 26.00% in the control group. There was a significant difference. Conclusion:Warm acupuncture at Biguan(ST 31) is effective in treating post-apoplectic restless legs syndrome.