Clinical analysis of reconstruction of lateral wall and femoral moment in the treatment of Evans Jensen type V intertrochanteric fracture / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of proximal femoral nail anti rotation (PFNA) and titanium plate in the treatment of Evans Jensen type V intertrochanteric fractures.@*METHODS@#From October 2013 to March 2016, 30 patients with Evans Jensen type V intertrochanteric fractures were analyzed. According to the operation methods, they were divided into two groups:16 cases of closed reduction and PFNA internal fixation;14 cases of small incision incision reconstruction of titanium plate reconstruction of femoral moment and lateral wall PFNA internal fixation. The operation (blood loss, operation duration), postoperative rehabilitation (postoperative ambulation time, bone healing time), operation related complications (internal fixation fracture, withdrawal, spiral blade cutting out) were observed and compared between the two groups. Harris score of hip joint function was performed 12 months after operation, and the loss degree of cervical trunk angle was observed and compared.@*RESULTS@#All the 30 patients were followed up for 12 to 18 months. The blood loss and operation duration of open reduction group were significantly greater than those of closed reduction group (@*CONCLUSION@#Evans Jensen was treated with PFNA intramedullary fixation through reduction and fixation of femoral moment and lateral wall with reconstruction titanium plate Vtype intertrochanteric fracture can restore the support of femoral moment and lateral wall to femoral head and neck, improve the stability of fracture end and internal fixation after operation, and reduce the risk of fracture end displacement, internal fixation loosening, cutting out and even fracture after treatment with PFNA alone. To shorten the bed time of elderly patients and reduce the operation related complications, it provides a new idea and method for the treatment of Evans Jensen type V intertrochanteric fracture.

Sphingosine-1-phosphate signal transducer and activator of transcription 3 signaling pathway contributes to baicalein-mediated inhibition of dextran sulfate sodium-induced experimental colitis in mice / 中华医学杂志(英文版)

BACKGROUND@#Baicalein has been shown to have anti-inflammatory and anti-tumor activities. However, the mechanisms underlying its anti-inflammatory effect on colitis remain unclear.@*METHODS@#A dextran sodium sulfate (DSS)-induced model of acute colitis was established in BALB/c mice (6-8 weeks old, weighing 18-22 g). Six groups of mice received: (1) water for 10 days (control), n = 6; (2) DSS 4% solution in the drinking water for 7 days, followed by normal water for 3 days, n = 7; (3), (4), and (5) as for group 2 plus baicalein (10, 20, 40 mg/kg) administered once daily starting on day 1, n = 6; and (6) as for (2) plus 5-aminosalicylic acid (50 mg/kg) administered once daily starting on day 1, n = 6. Body weights, stool consistency, and hematochezia were recorded, and the severity of colitis was evaluated using a disease activity index. On day 11, the mice were euthanized, and organs and blood were collected for analysis. Serum inflammatory factors were detected by enzyme-linked immunosorbent assay; CD11b-positive cells were analyzed by immunofluorescence microscopy; expression of retinoic-acid-receptor-related orphan nuclear receptor gamma, sphingosine kinase 1 (SPHK1), and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) was detected by immunohistochemistry; and expression of nucleotide-binding oligomerization domain 2 (NOD2), SPHK1, sphingosine 1-phosphate receptor 1 (S1PR1), total STAT3, and p-STAT3 were detected by western blotting analysis. Inter-group differences were compared using Student's t test.@*RESULTS@#Baicalein treatment dose-dependently reduced DSS-induced weight loss (P < 0.01 or P < 0.05), splenomegaly (P < 0.01), and colonic damage, as reflected by amelioration of diarrhea, rectal bleeding, and colonic ulceration, congestion, edema (shown as colon length, P < 0.05 or P < 0.01), and inflammatory cell infiltration. Baicalein also significantly decreased the levels of inflammatory mediators in the serum (P < 0.01) and colon, and significantly inhibited expression of NOD2 SPHK1, S1PR1, and p-STAT3 in the colon (P < 0.05).@*CONCLUSIONS@#Baicalein treatment ameliorated colitis in mice by inhibiting S1P-STAT3 signaling, suggesting that this flavonoid might be beneficial in the treatment of colitis.

PFNA combined reconstruction and locking titanium plate for the treatment of comminuted femoral intertrochanteric fractures involving lateral wall / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the operative effect of PFNA combined with reconstructive locking plate on the treatment of comminuted femoral intertrochanteric fracture which involving the lateral wall.</p><p><b>METHODS</b>A total of 35 patients with comminuted femoral intertrochanteric fractures involving the lateral wall were surgically treated from November 2014 to January 2016. According to whether there was reconstruction of the lateral wall or not and the internal fixation method, the patients were divided into PFNA group (no reconstruction of the lateral wall), PFNA recontruction group (reconstructive locking plate was used to reconstruct the lateral wall, PFNA internal fixation). The clinical curative effect was evaluated by the analysis of operation time, intraoperative blood loss, postoperative activity time, the time of fracture healing, complications, and hip joint Harris score at 12 months after operation.</p><p><b>RESULTS</b>All 35 patients completed the operation successfully. All the incisions were healed by first intention and no incision infection or fat liquefaction occurred. All 35 patients were followed up from 12 to 16 months with an average of 14.4 months. All patients had bone healing. There was no statistical significant in surgery time and intraoperative blood loss between two groups(>0.05). There were 5 postoperative complications in the PFNA group and 1 in the PFNA combined with reconstructive locking plate group. There was a statistical difference between two groups(<0.05). The postoperative activity time, bone healing time, complications, and Harris score of PFNA reconstruction group were all superior to PFNA group, there were statistically significant differences between two groups.</p><p><b>CONCLUSIONS</b>Although the operation time and blood loss of PFNA combined with reconstructive locking plate in treatment of comminuted femoral intertrochanteric fracture which involving the lateral wall are more than those in the PFNA group, and the surgical trauma is larger than PFNA, the fracture healing time, postoperative activity time, and hip joint function were all superior to those of the PFNA group, which can effectively shorten the postoperative bed rest time, and reduce bed complications as well as improve hip joint function.</p>