ABSTRACT
BACKGROUND: Edaravone, an effective free radical scavenger, has been reported to significantly improve the rehabilitation of limb locomotion after spinal cord injury (SCI), but the underlying mechanism remains unclear. OBJECTIVE: To explore the mechanism underlying edaravone promoting the recovery of limb locomotion in rats with SCI by observing the Basso, Beattie, Bresnahan scores and expression levels of collagen type I and IV. METHODS: Thirty-six rats were randomly allocated into three groups (n=12 per group): sham group (laminectomy plus intraperitoneal injection of normal saline), model group (SCI model by NYU impactor plus intraperitoneal injection of normal saline), and edaravone group (SCI model by NYU impactor plus intraperitoneal injection of edaravone). All rats were given the administration at the 1stday post-SCI for consecutive 7 days. The Basso, Beattie, Bresnahan scores were tested at 1, 3, 5 and 7 days post treatment. On day 7, all rats were sacrificed to remove the spinal cord, and the morphology of neurons in the spinal cord were observed by Nissl staining; the expression levels of collagen type I and IV were detected by immunohistochemistry and western blot assays. RESULTS AND CONCLUSION: Compared with the model group, the Basso, Beattie, Bresnahan scores in the edaravone group were significantly increased at day 5 post treatment (P < 0.05). Nissl staining showed a clear boundary between grey matter and white matter, and a large nucleolus in the neurocytoplasm in the sham group; there was a complete structure of neurons, slight cellular swelling and small hematoma area in the edaravone group; many and large cavitations and swollen nucleus were found in the neurons, even without nucleolus. Immunohistochemistry and western blot assay results showed that the expression levels of collagen type I and IV in the edaravone group were significantly higher than those in the model group (P < 0.05). These results indicate that edaravone can promote the recovery of limb locomotion of rats with SCI,probably via up-regulating the expression levels of collagen type I and IV.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the treating effects of different intramedullary nailing methods on tibial fractures in adults.</p><p><b>METHODS</b>Literature reports in both Chinese and English languages were retrieved (from the earliest available records to October 1, 2013) from the PubMed, FMJS, CNKI, Wanfang Data using randomized controlled trials (RCTs) to compare reamed and unreamed intramedullary nailing for treatment of tibial fractures. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.0 was used for data-analysis.</p><p><b>RESULTS</b>A total of 12 randomized controlled trials, comprising 985 patients (475 in the unreamed group and 510 in the reamed group), were eligible for inclusion in this meta-analysis. The results of meta-analysis showed that there were no statistically significant differences between the two methods in the reported outcomes of infection (RR=0.64; 95%CI, 0.39 to 1.07; P=0.09), compartment syndrome (RR=1.44; 95%CI, 0.8 to 2.41; P=0.16), thrombosis (RR=1.29; 95%CI, 0.43 to 3.87; P=0.64), time to union (WMD=5.01; 95%CI, -1.78 to 11.80; P=0.15), delayed union (nonunion) (RR=1.56; 95%CI, 0.97 to 2.49; P=0.06), malunion (RR=1.75; 95%CI, 1.00 to 3.08; P=0.05) and knee pain (RR=0.94; 95%CI, 0.73 to 1.22; P=0.66). But there was a significantly higher fixation failure rate in the unreamed group than in the reamed group (RR=4.29; 95%CI, 2.58 to 7.14; P<0.00001).</p><p><b>CONCLUSION</b>There is no significant difference in the reamed and unreamed intramedullary nailing for the treatment of tibial fractures, but our result recommends reamed nails for the treatment of closed tibial fractures for their lower fixation failure rate.</p>
Subject(s)
Humans , Bone Nails , Fracture Fixation, Intramedullary , Methods , Tibial Fractures , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapeutic effects of microsurgical one-stage repair of hand flexor tendon injuries.</p><p><b>METHODS</b>Among 97 patients with (182 flexor tendons) hand injuries, 59 patients were male and 38 patients were female, ranging in age from 6 to 65 years, with an average of 32 years. Twenty-two patients got injuries by glasses, 32 patients got injuries by knife, 29 patients got injuries by saw, and 14 patients got crush injuries. The tendon injuries in this study consisted of 12 cases of I zone, 35 cases of II zone, 28 cases of III zone, 8 cases of IV zone and 14 cases of V zone. Sixty-eight patients complicated with injuries of blood vessel and nerve, and 53 patients also had fingers fractures. All the patients were treated with modified Kessler method to repair tendon at one-stage, and were given early rehabilitation step by step.</p><p><b>RESULTS</b>After the treatment, 97 patients were followed up from 3 to 24 months. According to TAM standard, 48 patients got an excellent result, 39 good, 8 fair and 2 bad.</p><p><b>CONCLUSION</b>Microsurgical one-stage tendon repair should be applied. Early rehabilitation and microsurgery repair are important for preventing tendon adhesion.</p>