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Objective To investigate the therapeutic effect of anteromedial ankle approach for talus fracture.Methods From January 2012 to October 2018,the data of 28 cases of talus fracture treated by anteromedial ankle approach were retrospectively analyzed,including 26 males and 2 females,aged 24-61 years with an average of 38.6 years.All 25 cases of closed injuries and 3 cases of open injuries were fresh injuries.There were 16 cases of traffic injuries,8 falling injuries,2 heavy object injuries and 2 sprains.Among the 28 patients,17 were talus neck fractures,and according to Hawkins talus neck fracture classification,there were 1 case of type Ⅰ,12 type Ⅱ,and 4 type Ⅲ.There were 11 cases of talus fracture,which were classified according to Sneppen talus fracture types:2 cases of type Ⅰ,8 cases of type Ⅱ and 1 case of type Ⅴ.Among them,2 cases of talus neck fracture complicated with T12 vertebral body fractures and 2 cases complicated with calcaneal fractures.The time from injury to operation for 3 patients with open fracture was 3-6 hours.25 cases of closed fracture injuries took 2-10 hours to operate,with an average time of 5.6 hours.All patients were fixed with cannulated screws through the anteromedial ankle approach.The weight-bearing time and strength of lower limbs were determined according to fracture healing after surgery.The ankle function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) Score.Results All 28 patients were followed up for 23 to 82 months,with an average of 37.5 months.All fractures healed.The healing time of talus neck fracture was 3.5-8 months,with an average of 5 months.The healing time of talus fracture was 3-7 months,averaging 4.5 months.At the latest follow-up,AOFAS score ranged from 68 to 100,with an average of 82.5 points,including excellent in 15 cases,good in 8 cases,fair in 4 cases and poor in 1 case,with the excellent and good rate of 82.1％ (23/28).There were no signs of fracture displacement,malunion,loosening and prolapse of internal fixation,fracture and ischemic necrosis of talus after operation.Traumatic arthritis occurred in 9 patients,with an incidence rate of 32.1％ (9/28).Tibial joint was involved in 5 cases,talus joint in 3 cases,tibialis in 1 case and talus joint in 1 case.Among them,traumatic arthritis occurred in 2 cases of open injury.Nine patients (32.1％) suffered from traumatic arthritis 6-10 months after operation,with an average of 8 months.According to conservative treatments such as weight control,ankle immobilization,physiotherapy,anti-inflammatory and analgesic,nutrition of articular cartilage drugs,joint traction and plasty were given.The patients' conditions improved to different degrees and could tolerate walking and normal life and work.Conclusion The anteromedial ankle approach has the advantages of minimal vessel injuries,clear exposure for direct reduction,low rate of necrosis of talus and satisfactory curative effect.
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Objective:To study the role of TNF-?in the mechanism of hepatocyte apoptosis induced by intestinal perforations due to abdominal firearm wound. Methods:A total of 42 Chang-Bai piglets were divided randomly into 7 groups: control group and wounded 1, 2 , 4, 8, 12, 24 hour groups.The model of intestinal perforations due to abdominal firearm wound were established in wounded groups. Levels of plasma endotoxin were measured using ehromogenic limulus amehoeyte lysate test.Hepatic TNF-? content was measured with immunohistochemical staining and image analysis in all groups. Hepatocyte apoptosis indexes and serum TNF-? levels were determined at the same time. Results: Levels of plasma endotoxin, serum TNF-?, hepatic TNF-? content and hepatocyte apoptosis indexes in wounded groups were all significantly elevated compared with control group(P
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Objective:To study the role of NF- ?B in the mechanism of liver injury following intestinal perforations due to abdominal firearm wound. Methods:A total of 42 Chang-Bai piglets were assigned randomly into 7 groups: control group and wounded 1, 2, 4, 8, 12, 24 hours group.The model of intestinal perforations due to abdominal firearm wound was established in wounded groups. Hepatic NF-?B and TNF-? content was measured with immunohistochemical staining and image analysis in all groups. Hepatocyte apoptosis indexes and serum ALT levels were also determined at the same time. The alterations of hepatic tissue were observed under light microscope. Results: Levels of hepatic NF-?B activity in wounded groups were significantly elevated compared with control group, and two peaks appeared in 1 h group and 8 h group, respectively (P
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Objective To summarize the role of nuclear factor kappa B(NF-?B) in the occurrence and progression of various sorts of liver injury.Methods Literatures on the structures,property of molecular biology and function of NF-?B,as well as its relationships with liver injury were collected and reviewed.Results NF-?B was an important nuclear factor existed in cells widely distributed in most cell types.The activation of NF-?B was induced by various sorts of liver injury.The activated NF-?B could affect the liver injury by regulating cytokines,adhesion molecules,and activating factor involving in immunologic reaction,inflammatory reaction and the apoptosis.Conclusion NF-?B plays an important role during the occurrence and progression of liver injury,and may become a new target in the treatment of liver injury.
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0.05) .The total survival rate of N group and H I group was significantly higher than H II group(P0.05) .The abdominal stinking leak was more severe and death rate was higher in N group and H I group than H II group.Conclusion:Dry heat environment in the desert could obviously impair the total survival rate of pigs.