Application of spiral CT image 3D reconstruction in severe talar neck fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To explore the application of the spiral computerized tomography (CT) image three-dimensional (3D) reconstruction technique associated with the conventional radiography in the diagnosis and treatment of severe talar neck fracture.</p><p><b>METHODS</b>Using the multi-slice spiral CT image 3D reconstruction technique, we analysed 11 cases of talar neck fracture. The fractures were reduced and fixed through a minimal incision and internal fixation with titanium cannulated lag screws.</p><p><b>RESULTS</b>In the 11 cases, the results of CT image 3D reconstruction were in concordance with plain radiograph in 6 case of Hawkins type II. And the remaining 5 cases of Hawkins types III and IV could not be classified exactly only by radiographs, one of whom was misdiagnosed. After using the CT image 3D reconstruction, the 5 cases were classified exactly before osteosynthesis. The classifications of these 11 cases were confirmed finally by surgical findings. The duration of operation were 45-140 min, averaging 81 min (including the duration of C-arm fluoroscopy). X-ray exposure time was 6-58 seconds, averaging 22 seconds. The blood loss was less than 100 ml. The fracture union was achieved in 3 months. No nonunion, talus avascular necrosis or joint surface collapse occurred. Postoperative follow-up was from 1 to 25 months. According to Hawkins score, excellent result was found in 6 type II cases and 1 type III case; good result in 1 type III case with both medial and lateral malleolar fracture, 1 type III with medial malleolus fractures and 1 open type III; fair result in 1 open type IV with lateral malleolus fracture.</p><p><b>CONCLUSIONS</b>By using the multi-slice spiral CT image 3D reconstruction associated with radiography to diagnose and treat severe talar neck fractures, the accuracy of diagnosis can be improved obviously. Based on this technique, more consummate operational plan can be designed and performed so as to achieve a better therapeutic effect.</p>

Gene expression profile related to inflammation in rat model of traumatic deep vein thrombosis / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the relationship between inflammation and traumatic deep vein thrombosis (TDVT).</p><p><b>METHODS</b>A rat model of deep venous thrombosis was established by directly clamping femoral vein. Based on the different biological situations of femoral vein thrombosis and observation phases, 150 SD rats were divided into 7 groups. Inflammatory cells in vein wall of each group were counted. The fold change and cluster analysis were applied to study the change of gene expression during the development of venous thrombosis. Especially, the genes related to inflammation, fibrinolysis, coagulation of endothelium were analyzed in detail.</p><p><b>RESULTS</b>The inflammation cells in femoral vein wall were mostly neutrophilic granulocytes in Groups B, C and D, while they were lymphocytes in Groups E, F and G. Compared with Groups A, B, E and G, the inflammation cell counts in Groups C, D and F were much higher (P less than 0.05). The results of fold-change analysis showed that 2 504 genes (Log 2 ratio > or = 1 or < or = 1) presented different expressions in the process of TDVT. Most of these genes'functions were not clarified so far and the genes with known functions were involved in inflammation, DNA-dependent transcription regulation, blood coagulation, fibrinolysis, etc. Among them, 23 genes related to inflammation had different expressions during TDVT. The cluster analysis showed that the expression changes of several genes, such as IL-1 alpha, IL-1 beta, IL-6, Cinc2, corresponded with the development of femoral vein thrombosis.</p><p><b>CONCLUSION</b>There is a close relationship between the genes related to inflammation and deep vein thrombosis induced by direct vascular trauma.</p>