ABSTRACT
OBJECTIVE@#To explore clinical effect of adult ankle fracture with Tillaux-Chaput fracture block.@*METHODS@#From January 2014 to December 2018, 15 patients with adult ankle fracture with Tillaux-Chaput fracture block were performed opertaion, including 9 males and 6 females, aged from 27 to 67 years old with an average of (45.6±14.3) years old, 8 patients on the left side and 7 patients on the right side. Fracture healing and complications were observed, American Orthopaedic Foot and Ankle Society(AOFAS) was used to evaluate recovery of ankle joint function.@*RESULTS@#All patients were followed up for 18 to 70 months with an average of (38.1±9.9) months. The incisions healed well at stageⅠ. X-ray reexamination showed all fractures healed well without loosening or breakage of internalfixation. Two patients had symptoms of superficial peroneal nerve injury and recovered gradually after nerve nourishing therapy. Three patients mainfested slightly limits of flexion and extension of ankle joint. AOFAS score of ankle and hind foot at the latest follow up was (85.6±7.9), 9 patients got excellent results, 4 good and 2 fair.@*CONCLUSION@#Fix Tillaux-Chaput fracture block with dentate steel plate has advantages of easy operation, stable fixation, and is beneficial to recovery of ankle function. It is not necessary to fix tibiofibular syndesmosis with screws.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ankle Fractures/surgery , Ankle Joint/surgery , Fracture Fixation, Internal , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To investigate the regulatory T cells (Treg) induced by 2, 3, 7, 8-tetrachloro-dibenzo-p-dioxin (TCDD) on the aryl hydrocarbon receptor activator from na?ve T cells, in collagen-induced arthritis (CIA)-rheumatoid arthritis (RA) mouse in the correction of rheumatoid arthritis pathological process on Th17/Treg cell imbalance. Methods ① Rat CIA model was established by bovine Ⅱ collagen injection. The rats were divided into 3 groups: the normal group (N), the CIA model group (C), and the TCDD group (T).② The percentage of Th17 and Treg from peripheral blood mononuclear cells (PBMCs) were analyzed with flow cytometry (FCM). Th17 and Treg cells related cytokine including interleukin (IL)-1β, IL-6, IL-17A, IL-23, tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β were measured with enzyme linked immunosorbent assay (ELISA). ③ The changes of the arthritis parameters, and radiological of T/NT before and after treatment were observed. ④ After two weeks of treatment, the rats were killed. The swollen joints were used for pathological assessment and arthritic pathology injury score was evaluated. ⑤ All data were analyzed by one-way analysis of variance (ANOVA) test and t test. Results In group C:When the second immunization was compared with the first, the percentage of Th17 cells was significantly increased [(2.99 ±0.16)%, (4.02 ± 0.33)%, t=-6.82, P<0.01], while Treg cells were significantly reduced [(2.67 ±0.57)%, (1.79 ±0.39)%, t=3.11, P=0.000], Th17/Treg was significantly increased (1.14 ±0.14, 2.27 ±0.39, t=-4.53, P=0.039). In group T, the percentage of Th17 cells were significantly reduced [(2.69±0.24)%, (1.21±0.25)%, t=5.12, P<0.01] before and after treatment, while Treg cells were significantly increased [(2.76 ±0.36)%, (3.78 ±0.22)%, t=-6.24, P<0.01], Th17/Treg was significantly reduced (1.08±0.07, 0.21±0.05, t=-11.92, P=0.027). In group C:When the second immunization was compared with the first, the Th17 cells related cytokines were significantly increased inclu-ding IL-1 [(96±12) pg/ml, (153±18) pg/ml, t=-13.24, P<0.01], IL-6 [(246±14) pg/ml, (295±15) pg/ml, t=-9.41, P=0.000], IL-17 [(76 ±14) pg/ml, (99 ±16) pg/ml, t=-5.78, P<0.01], IL-23 [(85 ±9) pg/ml, (102 ±11 ( pg/ml, t=-11.71, P<0.01], TNF-α [(303 ±12) pg/ml, (345 ±17) pg/ml, t=-15.56, P=0.007], while Treg cells related cytokines TGF-β was significantly reduced [(42 ±7) ng/ml, (35 ±8) ng/ml, t=7.52, P=0.012]. Th17 cells related cytokines were significantly reduced including IL-1 [(93 ±10) pg/ml, (79 ±8) pg/ml, t=10.52, P<0.01], IL-6 [(245 ±11) pg/ml, (151 ±8) pg/ml, t=19.23, P<0.01], IL-17 [(76 ±10) pg/ml, (62 ±9) pg/ml, t=7.37, P=0.005], IL-23 [(84 ±11) pg/ml, (38 ±6) pg/ml, t=14.48, P=0.000], TNF-α [(294 ±8) ng/ml, (195 ±9) ng/ml, t=23.35, P<0.01], while Treg cells related cytokine TGF-β was significantly increased (41 ±8, 61 ±10, t=-10.61, P=0.000. Conclusion TCDD can increase Treg cells, reduce Th17 cells, so the Th17/Treg cell in RA patho-genesis could be re-balanced.