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Objective:To analyze the injury characteristics of peritalar dislocations using ankle models reconstructed with software Mimics.Methods:A retrospective study was conducted to analyze the medical records of 36 patients with peritalar dislocation who had been treated at Department of Orthopaedics, The Fourth Hospital of Wuhan from January 2008 to April 2022. There were 28 males and 8 females with an age of (46.0±14.6) years, and 16 left and 20 right limbs. Their CT data were imported into software Mimics to reconstruct ankle models to observe the fractures of the postero-medial process of the talus, the affiliated injuries to the surrounding bone structures outside the talus, and the complete or incomplete dislocations of the talonavicular articulation.Results:32 patients (88.9%, 32/36) had fracture of the postero-medial process of the talus, and 24 patients (66.7%, 24/36) a total of 33 affiliated injuries to the surrounding bone structures outside the talus, including 12 lateral malleolus ones, 4 medial malleolus ones, 7 scaphoid ones, 6 calcaneus ones, 3 fractures of the cuboid and 1 fracture of the fifth metatarsal. Sixteen patients were complicated with 1 affiliated injury, 7 patients with 2 affiliated injuries, and 1 patient with 3 affiliated injuries. The 8 patients with 2 or more affiliated injuries all had complete dislocation of the talonavicular articulation. Of the 36 patients, 26 had complete dislocation of the talonavicular articulation and 10 incomplete dislocation of the talonavicular articulation. The incidence of affiliated injuries [84.6% (22/26)] in the patients with complete dislocation of the talonavicular articulation was significantly higher than that [20.0% (2/10)] in those with incomplete dislocation of the talonavicular articulation ( P=0.001). Conclusions:Most of the peritalar dislocations are combined with the fracture of the postero-medial process of the talus. The incidence of complete dislocation of the talonavicular articulation is high. Patients with complete dislocation of the talonavicular articulation are more likely to have an affiliated injury, or even more than two injuries.
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Objective:To investigate the effects of exenatide on podocyte in diabetic nephropathy mice.Methods:Diabetic nephropathy mice models were induced by using streptozocin-treated C57BL/6J mice on high fat diets, which were randomized by random number table to diabetic nephropathy control group (DN group, n=8) and exenatide treatment diabetic nephropathy group (DN+ Ex group, n=8). The C57BL/6J mice on normal chow diet were used as normal control group (NC group, n=8). After the intervention, blood glucose, renal function, and urine albumin/creatinine ratio were measured. Pathological glomerular changes were observed by pexiodic acid-Schiff stain (PAS) staining. The mRNA expression of profibrotic molecules Collagen Ⅳ, transforming growth factor-β (TGF-β), and Fibronectin in glomerular lysates were measured by realtime quantitative PCR (RT-PCR). Podocyte injury and apoptosis were evaluated by immunofluorescent staining and transmission electron microscopy. The expression of Nephrin, Cleaved caspase-3, protein kinase B (Akt), and phosphorylated Akt (p-Akt) in glomerular lysates were examined by western blotting. Results:Compared with the DN group, urine albumin/creatinine ratio was significantly decreased in the DN+ Ex group ( P<0.01). PAS staining and analysis found that exenatide administration ameliorated mesangial matrix expansion and glomerular hypertrophyin in DN group ( P<0.05). RT-PCR analyses showed that the glomerular expression for Fibronectin, TGF-β, and Collagen Ⅳ were significantly decreased in the DN+ Ex group compared with the DN group ( P<0.01). Immunofluorescent staining and transmission electron microscopy revealed that exenatide treatment improved podocyte injury and apoptosis in DN group. Western blotting analyses showed that exenatide increased the Nephrin expression, decreased the Cleaved caspase-3 expression, increased the p-Akt expression in glomerular lysatesin diabetic nephropathy mice ( P<0.01). Conclusion:Exenatide attenuates podocyte injury and apoptosis and proteinuria, and prevents the progression of diabetic nephropathy mice. Phosphatidylinositol 3-kinase (PI3K)/Akt pathway in glomerular lysates may be related to the protective effects of exenatide.