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OBJECTIVE@#To explore the short-term clinical efficacy of manipulation reduction-combined with small splint and 3D printing wrist brace external fixation of wrist brace for Colles fracture and the advantages of using the brace.@*METHODS@#A total of 60 patients with Colles fractures who were treated in Zhongshan Hospital of Traditional Chinese Medicine from February to December 2017 were selected. Patients were randomly divided into 2 groups according to the order of treatment, with 30 patients in the control group, including 13 males and 17 females, aged from 16 to 66 years, with a mean of (49.46±12.63) years; the time from injury to consultation ranged from 3 to 18 h, averaged (6.86±3.15) h. In the experimental group, there were 30 cases, 12 males and 18 females, ranging in age from 14 to 68 years old, with a mean of (46.73±14.40) years old; the time from injury to consultation ranged from 3 to 19 h, averaged(7.06±3.45)h. All the patients in the experimental group and the control group were treated with the same doctor's manipulation to reduce the fracture. The small splints were applied for external fixation after the satisfactory reduction shown in the X-ray. After 1 week of fracture treatment, the small splints were removed from the patients in the experimental group and the 3D printing braces were replaced to maintain fixation until the fracture healed. In the control group, small splints were maintained until the fracture healed. Wrist joint X-ray films were taken before and after reduction and 4 weeks after reduction to observe the palmar inclination angle, ulnar deviation angle, radius height and compare; VAS score and swelling degree score were recorded before and after reduction for 1 and 2 weeks; Cooney and PRWE score of wrist joint were compared after 6 to 8 weeks of reduction.@*RESULTS@#The VAS score of 2 weeks after reduction was 2.40±0.49 in the experimental group and 2.43±0.50 in the control group. There was no statistical difference in the VAS score between the two groups before and after reduction(=0.364). The swelling degree of 2 weeks after reduction was 0.50±0.50 in the experimental group and 0.53±0.50 in the control group. There was no statistical difference in the swelling degree between the two groups before and after reduction(=0.746). The Cooney and PRWE scores of the experimental group were better than those of the control group 6 to 8 weeks after reduction (<0.05), and the anatomical characteristics of palmar inclination, ulnar deviation and radial shortening of the experimental group were better than those of the control group(<0.05).@*CONCLUSIONS@#3D printing braces are light and breathable, comfortable and beautiful, and convenient for dressing. The combination of small splint sequentially applied to Colles fracture has a definite clinical effect, which enriches the means of external fixation treatment. It is believed that with the deepening of clinical research, the design and materials of 3D printing braces as well as their application in future medical treatment will be further developed.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Braces , Colles' Fracture , Fracture Fixation , Printing, Three-Dimensional , Radius Fractures , SplintsABSTRACT
BACKGROUND: The expression of exogenous genes in mesenchymal stem cells is beneficial to enhance the transplantation effect and improve the differentiation rate. OBJECTIVE: To verify whether the transplantation of amniotic mesenchymal stem cells (AMSCs) can improve the renal function and blood coagulation in rats with nephrotic syndrome by means of vascular endothelial growth factor (VEGF) modification. METHODS: The 18 of 72 male Sprague-Dawley rats were assigned to normal group (without any treatment), and the other 54 rats were intravenously injected with doxorubicin to establish adriamycin nephropathy rat models which were randomly divided into three groups:model group (tail vein injection of 10 μL of 0.9% PBS injection), AMSCs group (tail vein injection of 10 Ml of AMSCs suspension), VEGF modified group (tail vein injection of 10 μL of VEGF modified AMSCs suspension). The injection in each group began at 24 hours after modeling, once a day for 3 consecutive days. The levels of total cholesterol (TC), triglyceride (TG), total protein (TP), albumin (Alb), high density lipoprotein (HDL), low density lipoprotein (LDL), creatinine (Cr), blood urea nitrogen (BUN) and coagulation index were measured by an automatic biochemical analyzer. The 24-hour urinary protein was determined by trichloroacetic acid method. The mRNA and protein expression of heparanase (HPA) and VEGF in renal tissue were detected by RT-PCR and western blot, respectively. RESULTS AND CONCLUSION: (1) Compared with the normal group, the contents of 24-hour urinary protein, TC, TG, LDL, Cr, BUN in the model group were significantly increased (P < 0.05), while the contents of TP, Alb, HDL were significantly decreased (P < 0.01). The serum levels of TC, TG, LDL, Cr, BUN in the AMSCs group and VEGF-modified group were significantly lower than those in the model group (P <0.05), while TP, Alb and HDL were significantly higher in the model group (P < 0.05). Compared with the AMSCs group, these indexes were significantly improved in the VEGF-modified group (P < 0.05). (2) The coagulation indexes of the model group showed a tendency of hypercoagulability. Compared with the model group, the hypercoagulability in the AMSCs and the VEGF-modified group were improved, especially in the VEGF-modified group. (3) The expression of HPA gene and protein in the model group was significantly higher than that in the normal group. The expression of HPA gene and protein in the AMSCs group and VEGF-modified group was lower than that in the model group. The expression of HPA gene and protein in the VEGF modified group was the lowest, while the expression of VEGF gene and protein in the VEGF modified group was the highest among the groups (P < 0.05), and there were significant differences between groups (P < 0.05). To conclude, VEGF gene-modified AMSCs can be transplanted via tail vein to improve renal function and hypercoagulable state in rats with nephrotic syndrome.
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BACKGROUND:Both salvia miltiorrhiza injection and adipose-derived stem cells have evident neuroprotection against cerebral infarction in rats.OBJECTIVE:To observe the effect of salvia miltiorrhiza injection combined with adipose-derived stem cell transplantation on cerebral infarction in rats and the levels of cyclooxygenase-2 (COX-2) and beta-amyloid protein (Aβ) in the serum and brain tissues.METHODS:A rat model of cerebral infarction was successfully established in 63 rats,and then the model rats were randomly divided into three groups (n=21 per group):model group (cerebral infarction group with 30 μL of PBS via the tail vein),stem cell group (transplantation of adipose-derived stem cells,30 μL,3x106/L,via the tail vein),salvia miltiorrhiza injection + adipose-derived stem cell transplantation(combined group with transplantation of adipose-derived stem cells,30 μL,3x106/L,via the tail vein and intraperitoneal injection of salvia miltiorrhiza injection,0.5g/(kg·d) for consecutive 7 days).The modified neurological severity scores of each group were evaluated before and at 1,2,3,and 4 weeks after treatment.At 3 weeks after treatment,MTT assay was used to detect the serum levels of COX-2 and Aβ;2,3,5-triphenyltetrazolium chloride staining was performed to detect infarction size;and RT-PCR and western blot assay were used to detect the mRNA and protein levels of COX-2 and Aβ in the brain tissues.RESULTS AND CONCLUSION:The modified neurological severity scores in the three groups were ranked as follows:combined group ＜ stem cell group ＜ model group,and there were significant differences between groups (P ＜ 0.05).Compared with the model group,the levels of COX-2 and Aβ in the serum and brain tissues at protein and mRNA levels were significantly lower in the stem cell group and combined group;compared with the stem cell group (P ＜ 0.05),the levels of COX-2 and Aβ were significantly lower in the combined group (P ＜ 0.05).The infarct size was smallest in the combined group,followed by the stem cell group,and biggest in the model group (P ＜ 0.05).To conclude,salvia miltiorrhiza injection combined with adipose-derived stem cell transplantation can improve the neurological function of rats after cerebral infarction,probably through reducing the levels of COX-2 and Aβ in the rat brain and serum.
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<p><b>OBJECTIVE</b>To evaluate clinical effect of micro-modified Fulkerson osteotomy under arthroscope in treating habituation patellar dislocation.</p><p><b>METHODS</b>Twenty patients of habituation patellar dislocation (25 knees) were treated by the medial retinaculum plication, lateral retinaculum releasing and modified Fulkerson osteotomy (tibial tubercle anteromedial transfer) under arthroscope. There were 5 males and 15 females with the age from 16- to 28-years-old (average of 21 years). The subjective symptoms and the joint function were evaluated according to Lysholm and Tegner scoring system.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 36 months with an average of 24 months. No found redislocation in the patients. The Lysholm score was 54.4 +/- 12.1 and 87.7 +/- 9.6 (t=2.33, P<0.05) before and after surgery respectively. The Tegner score was 2.8 +/- 0.8 and 5.1 +/- 1.3 (t=4.36, P<0.01) before and after surgery respectively.</p><p><b>CONCLUSION</b>Micro-modified Fulkerson osteotomy under arthroscope for the treatment of habituation patellar dislocation is a rescheduled in extend knee equipment, its advantages including affirmative effect, minor damage, quick rehabilitation, fewer complications and lower rate of recurrence after operation.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Osteotomy , Methods , Patella , Wounds and Injuries , General Surgery , Patellar Dislocation , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical efficacy of the pith decompression of the femoral head and fibular allograft transplantation in the treatment of early stage avascular necrosis.</p><p><b>METHODS</b>From January 2004 to November 2008, 32 hips of 25 patients with avascular necrosis of femoral head of Ia-IIIb period were treated by the pith decompression of the femoral head and fibular allograft transplantation, hollow lag screw fixation, included 17 males and 8 females, aged from 20 to 55 years old (39.1 years on average). Preoperative pain was from 2 to 14 months (means 5.5 months). All patients were applied on conventional X-ray films, MRI examination, Harris score.</p><p><b>RESULTS</b>The patients were followed up for 12 to 48 months (means 36.4 months). X-ray film showed 21 hips of 18 cases improved,6 hips of 4 cases unchanged, no collapse of articular surface, 3 hips of 2 cases deterioration, 2 hips of 1 case failed. Preoperative Harris score was (77.0 +/- 8.0) and postoperative (90.6 +/- 2.5), there was a significant difference (t = 1.67, P < 0.05).</p><p><b>CONCLUSION</b>Pith decompression of the femoral head and fibular allograft transplantation in the treatment of early stage avascular necrosis of femoral head has advantage of joint function in bed-ridden after a short time, quick recovery,clinical symptoms improved. Its short-term efficacy is certain but long-term efficacy is still need further observation.</p>