ABSTRACT
Objective To explore the clinical effect of peroneal artery perforator flap for the treatment of serious heel spoke injuries in children.Methods From July,2014 to September,2017,13 children with severe heel and ankle injuries were treated by peroneal artery perforator flap.There were 9 males and 4 females,with an average age of 6.5 years (ranged from 3 to 11 years).The size of flaps ranged from 10.0 cm×3.0 cm to 14.5 cm×5.0 cm.The donor sites were sutured directly or covered with skin grafting.Regular follow-up was performed to observe the survival status of the flap and the functional recovery of the ankle joint.Results Twelve flaps survived completely.One flap had partial marginal necrosis in the distal portion,which was healed after dressing.Partial inadequate venous return happened in 1 case,which also recovered by the removal of part of the suture.All cases were followed-up for 3 months to 20 months.The appearance,texture,and color of the flaps were similar to the surrounding skin.No ulcer occurred.All case acquired normal gait.Conclusion The peroneal artery perforator flap is a good option for reconstruction of serious heel spoke injuries in children.The flap has consistent blood supply while leaving minimal morbidity at donor site.
ABSTRACT
Objective To investigate the related mechanism of ligamentum flavum (LF) hypertrophy in diabetic pa-tients with lumbar spinal canal stenosis ( LSCS ) .Methods Twenty-four diabetes mellitus patients [ DM (+) ] and twenty normoglycemic patients [ DM (-) ] with LSCS were enrolled in this study .Sorbitol in LF was analyzed using D-Sorbitol/Xylitol test kit .The thickness of LF was measured by CT .The structure of LF was observed after HE and Masson's trichrome staining .The cell cycle and proliferation of fibroblastic cell NIH 3T3 line cultured in high glucose were analyzed .Sorbitol of NIH3T3 was detected under different backgrounds in vitro, normal glucose , high glucose and high glucose burdened with aldose reductase inhibitor ( ARI) , Epalrestat .The expression of inflammatory factors was detected by qPCR and Western blot under above different backgrounds .Results LF of diabetic patients exhibi-ted significantly higher level of sorbitol and pro-inflammatory cytokines , TGF-βand of CD68-positive staining than that of the normoglycemic subjects ( P<0.01 ) .The diabetic LF was significantly thicker than that of the controls , and showed evidence of degeneration .The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol , pro-inflammatory factors , and TGF-βcompared to the low glucose-cultured cells , and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor (P<0.05).Conclusions Sorbitol level of the LF is significantly increased in the DM patients with LSCS .Increased sorbitol recruites inflammatory factors and fibrogenic-related factor TGF-βin LF of DM patients with LSCS which may contributes to the LF hypertrophy .
ABSTRACT
Objective To investigate the clinical effects of scaphoid nonunion fractures by vascularized bone graft which can reconstruct fracture blood circulation. Methods From March 2013 to December 2014, 28 cases of patients with scaphoid fractures and nonunions were studied, including 16 males and 12 females whose age arranged from 19 to 33 years with a mean age of 26.2 years, for whom waist fractures and nonunions accounted 25 cases, and proximal end of scaphoid accounted 3 cases. The patients received treatments, vascularized radial periosteum graft was transversely implanted after radial periosteal flap pedicled on their current branch of the radial artery between the first and second tendinous sheath had been separated. Then 15 cases were fixed by Kirschner wire and 13 by Herbert screw. X?ray films were taken and checked regularly and periodically at 1th, 2nd, 3rd, 6th, 12th month after the operation to follow up fracture union and wrist function rehabilitation. Results All 28 cases of patients were followed up after operation for a period ranging from 5 to 12 months (with an average of 8 months). All patients with scaphoid fractures and nonunions were cured. The fractures and nonunions were clinically healed within 3 to 5 months and the patients didn't suffer from wrist pain basically. The wrist functions of those patients were evaluated according to modified Mayo wrist score:21 were rated as excellent, 5 as fine, 2 as fair, the excellent and good rate was 93%(26/28). The excellent and good rate of Kirsch?ner wire group was 93%(14/15), and the Herbert screw group was 92%(12/13). The difference in the excellent and good rate was not statistically significant between Kirschner wire group and Herbert screw group (χ2=0.011, P=0.916). Conclusion Fixed with Kirschner wire or Herbert screw, using vascularized radial periosteum graft to treat scaphoid fractures and nonunions has good short?term clinical effects. The operation manner with simple operation is an effective treatment, which can improve the blood sup?ply of the scaphoid fracture.
ABSTRACT
Objective To observe the effect of cinobufotalin freeze-dry powder on heart rate ( HR ) and electrocardiogram ( ECG) of SD rats and to provide experimental basis for monitoring its adverse effect on heart in clinical application. Methods The drug was administered into external jugular vein at constant speed throughout the whole experiment;standard-Ⅱ limb lead monitored the HR and ECG, and then the changes in HR and ECG before and after administration of cinobufotalin were compared. Results Thirty minutes after administration of cinobufotalin injection and cinobufotalin freeze-dry powder at middle dose and high dose, HR of the rats was significantly increased as compared with blank control group[(469±40) bpm, (466±29) bpm and (484±40) bpm vs. (411±17) bpm] (P0. 05). Conclusion Cinobufotalin freeze-dry powder has some side effects on rat heart and can increase HR, even lead to arrhythmia.