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AIM:To investigate the protective effect of non-mitogenic fibroblast growth factor 1 (nFGF1) on the aortic vascular function in streptozotocin (STZ)/high-fat diet (HFD)-induced type 2 diabetic rats and its underlying mechanisms. METHODS:Five-week-old male SD rats (n=30) were randomly divided into 3 groups (n=10 in each group),including normal control group,type 2 diabetic group and nFGF1 treatment group(type 2 diabetic rats were intra-peritoneally injected with 0.5 mg/kg nFGF1 every other day for 4 weeks). After the rats were sacrificed, blood glucose, cholesterol and triglyceride levels,aorta diastolic function and superoxide dismutase(SOD) level in the aorta of each group were measured. Besides,the protein levels of cyclooxygenase-2(COX-2),phosphorylated extracellular signal-regulated ki-nase (p-ERK) and endothelial nitric oxide synthase (eNOS) in the aorta were determined by Western blot. RESULTS:nFGF1 markedly lowered blood glucose, cholesterol and triglyceride levels, enhanced aorta SOD activity and upregulated protein level of eNOS in the type 2 diabetic rats. Furthermore,the increased protein levels of COX-2 and p-ERK in the type 2 diabetic rats were largely abrogated by nFGF1. CONCLUSION:nFGF1 effectively attenuates aortic vascular dysfunction in the type 2 diabetic rats,which may be associated with decreasing blood glucose,cholesterol and triglyceride levels,re-ducing inflammation and oxidative stress response,and activating eNOS signaling pathway.
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Objective To explore the clinical experience and surgical method of the repairment of frontal plantar tissue defects by using "tennis racket"-like flap with the medial plantar retrograde,and to study the reliability in the clinical application of the medial plantar retrograde flap.Methods From June 2011 to June 2016,"tennis racket"-like flap with the medial plantar retrograde was used to repair the frontal plantar tissue defects in 10 cases.The cutting range of flap was from 3.5 cm × 2.0 cm to 8.0 cm x 4.0 cm in size;in all patients the donor area was covered by skin grafts.Results All flaps survived and wounds healed by first intention.In 10 patients the donor sites healed primarily with a straight scar,and the appearance and texture of the flaps were satisfactory.All patients were followed up from 6 to 24 months (mean 12 months).According to the Chinese foot function evaluation standard trial evaluation,the outcomes were excellent in 9 cases,good in 7 cases,and medium in 2 cases.Conclusions "Tennis racket"-like flap with the medial plantar retrograde is less anatomic variation with reliable blood supply,and sensory recovery is quick;the donor site is a small crater and cicatrial contractures are light;the cost is low.All patients are treated on one session and therefore it is an ideal method for the repairment of frontal plantar tissue defects.
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<p><b>BACKGROUND</b>Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures. Distal locking screw prominence is one of the causes for soft tissue irritation. This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P) view in detecting distal locking screw penetrations during retrograde femoral nailing.</p><p><b>METHODS</b>The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT) images. After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure. The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur. A-P view, lateral condyle tangential view and medial condyle tangential view were obtained. All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not.</p><p><b>RESULTS</b>According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°. In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw) and 25.0% (medial condyle screw) at 4 mm, and 41.7% (lateral condyle screw) and 58.3% (medial condyle screw) at 6 mm. In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm. In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm. The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm) compared with the A-P view (P < 0.05).</p><p><b>CONCLUSIONS</b>The femoral condyles tangential views increased the accuracy of detecting screw penetrations on the medial and lateral condyles. Routine clinical use of the femoral condyles tangential views has the potential to increase accuracy in detecting distal locking screw penetration during retrograde femoral nailing.</p>
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Humans , Bone Screws , Femoral Fractures , Diagnostic Imaging , General Surgery , Fracture Fixation, Internal , Fracture Fixation, Intramedullary , Tomography, X-Ray ComputedABSTRACT
<p><b>BACKGROUND</b>Unstable pelvic fractures are complex and serious injuries. Selection of a fixation method for these fractures remains a challenging problem for orthopedic surgeons. This study aimed to compare the stability of Tile C pelvic fractures fixed with two iliosacral (IS) screws and minimally invasive adjustable plate (MIAP) combined with one IS screw.</p><p><b>METHODS</b>This study was a biomechanical experiment. Six embalmed specimens of the adult pelvis were used. The soft tissue was removed from the specimens, and the spines from the fourth lumbar vertebra to the proximal one-third of both femurs were retained. The pubic symphysis, bilateral sacroiliac joints and ligaments, bilateral hip joints, bilateral sacrotuberous ligaments, and bilateral sacrospinous ligaments were intact. Tile C pelvic fractures were made on the specimens. The symphysis pubis was fixed with a plate, and the fracture on the posterior pelvic ring was fixed with two kinds of internal fixation in turn. The specimens were placed in a biomechanical machine at a standing neutral posture. A cyclic vertical load of up to 500 N was applied, and displacement was recorded. Shifts in the fracture gap were measured by a grating displacement sensor.</p><p><b>STATISTICAL ANALYSIS USED</b>Paired-samples t-test.</p><p><b>RESULTS</b>Under the vertical load of 100, 200, 300, 400, and 500 N, the average displacement of the specimens fixed with MIAP combined with one IS screw was 0.46, 0.735, 1.377, 1.823, and 2.215 mm, respectively, which was significantly lower than that of specimens fixed with two IS screws under corresponding load (P < 0.05). Under the vertical load of 500 N, the shift in the fracture gap of specimens fixed with MIAP combined with one IS screw was 0.261 ± 0.095 mm, and that of specimens fixed with two IS screws was 0.809 ± 0.170 mm. The difference was significant (P < 0.05).</p><p><b>CONCLUSION</b>The stability of Tile C pelvic fractures fixed with MIAP combined with one IS screw was better than that fixed with two IS screws.</p>
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Adult , Humans , Male , Middle Aged , Bone Screws , Fracture Fixation, Internal , Methods , Fractures, Bone , General Surgery , Pelvic Bones , General SurgeryABSTRACT
Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduction and intramedullary nail fixation to determine the therapeutic effect of this closed reduction technique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a gentle traction was attempted on the limb. Usually, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the medullary cavity, and the "T" sharp handles were fixed on the Schanz pins. The fragments were then reduced by reversing the deforming forces for segmental fractures by two assistants. And then, the reduction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all patients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen (86.7%) patients had anatomic reduction and two of them (13.3%) had minor varus alignment of 3° and 5°. Knee stiffness was observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures with four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.
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Adult , Humans , Male , Middle Aged , Bone Nails , Femoral Fractures , Diagnostic Imaging , General Surgery , RadiographyABSTRACT
Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduction and intramedullary nail fixation to determine the therapeutic effect of this closed reduction technique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a gentle traction was attempted on the limb. Usually, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the medullary cavity, and the "T" sharp handles were fixed on the Schanz pins. The fragments were then reduced by reversing the deforming forces for segmental fractures by two assistants. And then, the reduction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all patients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen (86.7%) patients had anatomic reduction and two of them (13.3%) had minor varus alignment of 3° and 5°. Knee stiffness was observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures with four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.
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<p><b>OBJECTIVE</b>To study the histological change of microscrew-bone interface, detect the relative cytokine of gingival crevicular fluid, and explore the impossible mechanism of peri-implantitis.</p><p><b>METHODS</b>Four male Beagles were collected. Randomly select one side of animals jaw as the experimental group to induce the peri-implantitis, and another side as the control group. Four microscrews were implanted on each side. In the 1st, 2nd, 3rd, 4th weeks after implantation, collect peri-implant sulcular fluid (PISF) and detect tumor necrosis factor-alpha (TNF-alpha) levels before sacrificed, and the harvest tissue were observed in histological ways.</p><p><b>RESULTS</b>According to the extension of time after implantation, the experimental group showed visible progress of interface destruction: 1st week after implantation showed large numbers inflammatory cells collected at the neck but did not undermine the cortical bone; 2nd week after implantation, cortical bone were observed angular absorption; Bone resorption continued to develop and at the 4th week, bone resorption were enlarged to the second thread of microscrew and the interface was filled with a large number of collagen fibers.</p><p><b>CONCLUSION</b>The destruction of interface began at the neck of microscrew, and the further development was along the interface in depth. Both microscrews with peri-implantitis and the healthy controls showed the presence of TNF-alpha. Inflammation accumulation might trigger the up-regulation of TNF-alpha level, and the onset of inflammation would enhance the up-trend.</p>
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Animals , Dogs , Male , Bone and Bones , Dental Implants , Gingival Crevicular Fluid , Peri-Implantitis , Tumor Necrosis Factor-alphaABSTRACT
<p><b>OBJECTIVE</b>To assess the effect of the autologous venous external stents on intimal hyperplasia of the vein grafts in rabbits.</p><p><b>METHODS</b>Thirty-six male New Zealand white rabbits, aged 5 months and weighing 2.8 to 3.0 kg, were randomly divided into 3 groups: group A, group B and group C, with 12 rabbits in each group. First, a section about 6 cm long of vein was cut from the right external jugular vein of each rabbit and severed to have 3 equal-length segments. Next, each distal segment prepared for anastomosis. The proximal segment invaginating middle segment in group A and only middle segment in group B were used for the external stent. Later, the left common carotid artery was separated from surrounding tissue, from it a section about 0.5 cm long was cut away. Finally, the vein graft was inverted and end-to-end anastomosed to the two ends of the artery with a 9-0 suture. After bloodstream re-established, the diameter of each vein graft was measured. At 2 and 4 weeks postoperative, the graft veins were cut off and histologically examined by the means of HE staining and Masson staining. The smooth muscle cells (SMC) proliferation was studied by the immunohistochemical detection of proliferating cell nuclear antigen.</p><p><b>RESULTS</b>After bloodstream re-established, the diameters of vein graft of group A and group B and group C were (1.6 +/- 0.3) mm, (2.2 +/- 0.4) mm and (2.6 +/- 0.6) mm respectively (P < 0.05). At 4 weeks postoperative, the data of the ratio of intima to media thickness and the index of the proliferating cells of the intima were as follow: group A (1.01 +/- 0.07 and 6.84 +/- 1.98), group B (1.32 +/- 0.08 and 11.01 +/- 2.61), group C (1.55 +/- 0.03 and 14.96 +/- 4.14). Both the data of group A were obviously less than that in group B, and that of group B was less than group C (P < 0.05).</p><p><b>CONCLUSION</b>The autologous venous two-layer external stents inhibit intimal hyperplasia of the vein grafts.</p>
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Animals , Male , Rabbits , Hyperplasia , Pathology , Stents , Transplantation, Autologous , Tunica Intima , Pathology , Veins , Pathology , TransplantationABSTRACT
<p><b>OBJECTIVE</b>To assess the effect of the different treatments targeted at different types of radial head fracture and radial neck fracture.</p><p><b>METHODS</b>A retrospective study was performed in 87 patients from February 2006 to March 2007. Fifty-four patients with radial head fractures included 36 males and 18 females, aged from 18 to 65 years (the average age was 33); Forty of them resulted from crashing, 8 from traffic injury and 6 from falling injury. According to Mason classification system, there were 15 type I, 23 type II and 16 type III. Thirty-three patients with radial neck fractures included 21 males and 12 females, aged from 9 to 17 years (the average age was 13), 29 of them resulted from crashing, 1 from traffic injury and 3 from falling injury. According to O'Brien classification system, there were 8 type I, 14 type II and 11 type III. Type I of radial head fractures and radial neck fractures were immobilization with cast, the patients with type II of radial head fractures were treated with open reduction and micro-screw or T-trapezoid and bridge-shaped plate fixation and type III had operations to fix with bridge-shaped locked plate and repair the broken annular ligament, or replace heads with prosthesis. All patients with type II and type III of radial neck fractures were treated with closed reduction by leverage and percutaneous intra-medullary nailing.</p><p><b>RESULTS</b>The patients were followed up for 4-12 months (mean 7.2 months). The functional recovery degrees were evaluated with Wheeler's evaluation system. In group of radial head fractures, the results were excellent in 26 patients, good in 20, fair in 6 and poor in 2, the excellent and good rate was 85.2%. In group of radial neck fractures, the results were excellent in 20 patients, good in 9, fair in 4 and poor in no patient, and the excellent and good rate was 87.9%.</p><p><b>CONCLUSIONS</b>Different types of fractures should choose different surgical methods according to their characters. The excellent functional recovery depend on anatomical reduction, retaining the head of radius, early repairing and protecting the broken annular ligament of radius, and early functional training.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Arthroplasty, Replacement , Bone Plates , Bone Screws , Follow-Up Studies , Fracture Fixation, Internal , Methods , Radius Fractures , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
· AIM:To determine whether the multifocal visual evoked potential (mfVEP) can be used as a clinical method to assess the patients with optic nerve disease.· METHODS: Fifteen patients with optic nerve disease were examined in this study. All patients underwent visual acuity examination, slit-lamp inspection, ophthalmoscopy, Goldmann perimeter, fundus fiuorescein angiography, visual field and mfVEP. Although these patients with unilateral optic nerve damage,data from both eyes were included in the analysis.· RESULTS:In all patients the visual fields defect was demonstrated on the mfVEP and showed good correspondence in location of the scotoma. However, we also found some slight difference between visual field and mfVEP. In some locations, when the local visual fields were normal, mfVEP showed that its amplitude reduced. In reverse, when the local mfVEP seemed normal, visual field showed abnormity.· CONCLUSION:Multifocal visual evoked potential could be used as a clinical diagnosis option in patients with optic nerve disease. Local monocular damage to the optic nerve can be measured by an interocular comparison of the mfVEP.