ABSTRACT
Objective@#To explore the clinical effect of negative pressure wound therapy (NPWT) in emergency limb-salvage operation of destructive injury of limb.@*Methods@#From July 2014 to December 2017, 43 patients with destructive injury of limb in one side conformed to the inclusion criteria were admitted to our hospital. The patients were divided to NPWT group of 24 patients [ 21 males and 3 females, aged (38±10) years] and routine dressing change group of 19 patients [ 17 males and 2 females, aged (37±10) years] according to their treatment methods. After the emergency debridement, fracture external fixation, neurovascular exploration, and microsurgical repair were performed, NPWT were applied on wounds of patients in NPWT group and routine dressing change treatment on wounds of patients in routine dressing change group. On 7 to 10 days after the emergency operation, incidence of arterial embolism of patients in the two groups were calculated, and condition of wound infection of patients in the two groups were observed. Complete wound healing time and survival condition of limb were recorded. Data were processed with independent sample t test or chi-square test.@*Results@#Incidence of arterial embolism of patients in NPWT group on 7 to 10 days after the emergency operation was 6.67% (3/45), which was close to 5.56% (2/36) of patients in routine dressing change group (χ2=0.043, P>0.05). There was 1 patient with wound infection in NPWT group on 7 to 10 days after the emergency operation, obviously less than 6 patients in routine dressing change group (χ2=5.847, P<0.05). Complete wound healing time of patients in NPWT group was (30±4) d, significantly shorter than (36±8) d of patients in routine dressing change group (t=2.813, P<0.01). Limbs of 24 patients in NPWT group survived, which was close to 18 patients in routine dressing change group (χ2=1.293, P>0.05).@*Conclusions@#NPWT can significantly reduce tthe wound infection rate and shorten the time of wound healing of limb with destructive injury after emergency operation, which is worthy of popularization in clinic.
ABSTRACT
Objective@#To study the clinical effect of relaying peroneal artery perforator flap on anterior middle and lower tibia and donor-site defects repair.@*Methods@#From July 2014 to June 2017, 12 patients were included. The anterior middle-lower tibia soft tissue defects and the primary donor-sites were repaired by relaying peroneal artery perforator flaps, and the second donor-sites were directly closed. The size of anterior middle-lower tibia defects ranged from 5 cm × 3 cm to 13 cm × 9 cm. The flaps repairing the wounds ranged from 6 cm × 4 cm to 14 cm × 10 cm in size. The flaps restoring the first donor-site ranged from 5 cm×4 cm to 10 cm×6 cm in size. The clinical effect was evaluated by observing the appearance of the recipient sites and the donor sites.@*Results@#All the flaps survived uneventfully. All patients were followed up for 8-36 months (average 20 months). The flaps remained with good texture and color. The second donor-sites only left linear scar, which do not affect the overall appearance of limb.@*Conclusions@#The blood supply of relaying peroneal artery perforator is reliable without any disturbing of the main artery. The flap located on the lateral of the calf. The relaying peroneal artery perforator flap can repair the soft tissue defect at the anterior middle-lower tibia and improve the appearance of the first donor-site.
ABSTRACT
ObjectiveTo investigate the relationship between the single nucleotide polymorphisims in pre-miR-146a rs2910164 and miR-146a expression in rheumatoid arthritis(RA).MethodsPolymerase chain reaction- ligation detection reaction (PCR-LDR) was used to detect the pre-miR-146a rs2910164 single nucleotide polymorphisms in 123 patients with rheumatoid arthritis (RA) and 220 healthy controls.Expression of miR-146a in peripheral blood mononuclear cells was studied using quantitative realtime polymerase chain reaction (qRT-PCR) in 68 RA patients,10 osteoarthritis (OA) patients and 20 healthy controls.After application of glucocorticoid and NSAIDS combined with DMARDS for three months in 10 patients with active RA,miR-146a expression was again analyzed by qRT-PCR.Clinical characteristics including sex,age at onset,rheumatoid factor (RF),anti-cyclic citrullinated peptide (anti-CCP) antibody,RA activity (DAS28 ≥3.2) and bone erosion (X-ray ＞ Ⅰ stage) were taken into account.X2 test,One-Way ANOVA,t test and Pearson correlation were used for statistical analysis.ResultsThe polymorphisms of the pre-miR-146a rs2910164 were not correlated with susceptibility to RA (P＞0.05).There were no associations between pre-miR-146a rs2910164 genotypes and sex,age at onset,status of RF and antiCCP,RA activity,bone erosion and miR-146a expression in RA patients (P＞0.05 for each).MiR-146a expression was significantly higher in RA patients than that in OA patients and that in healthy controls( P＜0.01 for each) but did not differ between the latter two groups (P＞0.05).MiR-146a expression was significantly higher in active RA patients than that in inactive patients and that in healthy individuals (P＜0.01 for each).After treatment,miR-146a expression and DAS28 score were lower obviously (P＜0.05,P＜0.01,respectively).MiR-146a expression was positively correlated to ESR,CRP and DAS28 score (P＜0.01 for each),but not to RF titer and anti-CCP antibody titer (P＞0.05 for each).ConclusionThe polymorphisms of the pre-miR-146a rs2910164 are not associated with susceptibility to RA,and not correlated with clinical characteristics and miR-146a expression in RA patients.MiR-146a expression is upregulated in patients with RA,and may be a potentially useful marker of disease activity in these patients.