Knot-free anchor repair of anterior talofibular ligament under total ankle arthroscopy / 中国骨伤

OBJECTIVE@#To explore clinical effect of repairing anterior talofibular ligament with knot-free anchors under total ankle arthroscopy in treating chronic lateral ankle instability.@*METHODS@#From April 2018 to August 2021, 24 patients with chronic lateral ankle instability were treated with knot-free anchors under total ankle arthroscopy to repair anterior talofibular ligament, including 16 males and 8 females, aged from 22 to 42 years old with an average of(28.6±5.8) years old;the time from injury to opertaion ranged from 6 to 10 months with an average of(7.7±1.3) months. Preoperative and postoperative American Orhopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), talar tilt, anterior talar translation(ATT) were recorded and compared.@*RESULTS@#All patients were followed up from 10 to 12 months with an average of (10.2±1.14) months. Incision were healed at stageⅠ, and no infection, nerve injury and lateral ankle instability occurred. AOFAS score improved from(52.79±8.96) before opertaion to (93.00± 4.01) at 6 months after operation, 23 patients got excellent result and 1 good;VAS decreased from (5.50±0.98) before opertaion to (1.04±0.80) at 6 months after operation(P<0.05);talar tilt decreased from(9.16±2.09)° to (3.10±1.72)° at 3 months after operation(P<0.05);ATT decreased from(8.80±2.55) mm to (2.98±1.97) mm at 3 months after operation(P<0.05). Twenty-four patients drawer test and varus-valgus rotation wer negative.@*CONCLUSION@#Repairing anterior talofibular ligament with knot-free anchors under total ankle arthroscopy for the treatment of chronic lateral ankle instability has advantages of less trauma, less complications safe and reliable, and good recovery of ankle joint function.

Research progress on the pathogenesis of inflammatory external root resorption / 华西口腔医学杂志

Inflammatory external root resorption (IERR) refers to the pathological process of dissolving the hard tissue on the outer surface of the tooth root by the body's own immune system under the stimulation of various physical and chemical factors such as infection, stress, trauma and orthodontic treatment. Severe IERR can lead to endodontic and periodontal diseases, and even the loss of teeth. Therefore, understanding the etiology and the pathogenic mechanism of IERR are of importance in its prevention and treatment. This article will review the etiology and the regulation mechanisms of IERR.

Clinical therapeutic effect of a new bundle-to-bundle suturing method for acute Achilles tendon rupture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effect of a new bundle-to-bundle suturing method for acute Achilles tendon rupture.</p><p><b>METHODS</b>From April 2013 to January 2015, 15 patients with acute Achilles tendon rupture were treated with a new bundle-to-bundle suturing method including 12 males and 3 females with an average age of 37.5 years old ranging from 27 to 56 years old. All of them were immobilized by cast for 6 weeks on the underlying limbs, and were educated for a rehabilitation training during the follow-up.</p><p><b>RESULTS</b>All the patients were followed up for 9 to 17.5 months with an average of 13.5 months. According to the American Ankle Surgery Association (AOFAS), ankle and foot score was 93.3±3.5 at 6 months after operation. All patients got incomplete weight-bearing at 1.6 months on average after the operation, and back to primary work position 4.7 months later on average. All the wounds got primary healing. No incisional infection, necrosis of incisional marginal necrosis, rupture of the Achilles tendon, and gastrocnemius injury occurred.</p><p><b>CONCLUSIONS</b>The surgical treatment of acute Achilles tendon rupture with bundle-to-bundle suturing method has advantages of mini-invasion, a low rate of incision problems and quick function recovery, and was valuable spread in clinic.</p>

Headless pressure screw with local complication of PRP for the treatment of intra-articular fracture of old metatarsal / 中国骨伤

<p><b>OBJECTIVE</b>To discuss clinical effects of headless pressure screw with local complication of PRP in treating old metatarsal intra-articular fracture.</p><p><b>METHODS</b>From January 2010 to June 2016, 7 patients with old metatarsal intra-articular fracture treated by open reduction headless compression screw internal fixation by local application PRP, including 5 males and 2 females, aged from 21 to 52 years old, 5 patients injured by falling down and 2 patients caused by crushing, the time from injury to operation ranged from 3 to 6 weeks. Preoperative anteroposterior, lateral and oblique X-ray film and three-dimensional CT reconstruction were examined, and the results showed 2 patients on the second metatarsal, 2 patients on the third metatarsal, 3 patients on the fourth metatarsal. Regular X-ray as postoperative examination was observed, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle scoring system at the final follow-up was evaluated.</p><p><b>RESULTS</b>Seven patients were followed up from 6 to 17 months. All incisions healed at stage I without joint stiffness, traumatic arthritis and related complications. Imaging examination showed fracture reached bone healing, healing time ranged from 3 to 6 months. No joint stiffness and traumatic arthritis occurred. One of seven patients occurred stiffness of metatarsophalangeal joints. AOFAS score increased from 40.5±4.2 before operation to 85.0±10.5 at 12 months after operation, and 4 patients got excellent results, 2 moderate and 1 poor. The active motion of metatarsophalangeal joint showed dorsal flexion ranged from 35° to 40°, plantar flexion ranged from 25° to 35°.</p><p><b>CONCLUSIONS</b>Headless pressure screw with local complication of PRP in treating old metatarsal intra-articular fracture could recover articular surface of metatarsal head, improve metatarsophalangeal joints activity, which do not need the second operation, and could receive good clinical results with early exercise.</p>

Treatment of gouty arthritis of the first metatarsophalangeal joint by Masquelet technique / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical curative effects of a Masquelet technology in the treatment of gouty arthritis in the first metatarsophalangeal joint.</p><p><b>METHODS</b>From February 2012 to May 2016, 7 patients with the gouth arthritis of the first metatarsophalangeal joint were treated by the Masqueket technology. There were 5 males and 2 females, ranging in age from 42 to 58 years old, with an average age of 50 years old. During the regular follow up, the bone healing was assessed by the radiographic imaging, and the orthopaedic foot and ankle Association (AOFAS) ankle function scoring system was used for comprehensive evaluation.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 8 months, with a mean of 7 months. All the wounds obtained first intention healing, and there were no complications such as wound infection, flap necrosis and other soft tissue complications. The time to bone healing was 3 to 4 months, with an average of 3.6 months. The AOFAS score was increased from preoperative 42.5±4.6 to postoperative 85.0±10.5.</p><p><b>CONCLUSIONS</b>The application of Masquelet technique in the treatment of first metatarsophalangeal joint gouty arthritis achieves obvious symptom relief, has less complications, and can effectively improve the quality of life of patients, which is a new and effective treatment.</p>

Bone morphogenetic protein 2-induced human dental pulp cell differentiation involves p38 mitogen-activated protein kinase-activated canonical WNT pathway / 国际口腔科学杂志·英文版

Both bone morphogenetic protein 2 (BMP2) and the wingless-type MMTV integration site (WNT)/β-catenin signalling pathway play important roles in odontoblast differentiation and dentinogenesis. Cross-talk between BMP2 and WNT/β-catenin in osteoblast differentiation and bone formation has been identified. However, the roles and mechanisms of the canonical WNT pathway in the regulation of BMP2 in dental pulp injury and repair remain largely unknown. Here, we demonstrate that BMP2 promotes the differentiation of human dental pulp cells (HDPCs) by activating WNT/β-catenin signalling, which is further mediated by p38 mitogen-activated protein kinase (MAPK) in vitro. BMP2 stimulation upregulated the expression of β-catenin in HDPCs, which was abolished by SB203580 but not by Noggin or LDN193189. Furthermore, BMP2 enhanced cell differentiation, which was not fully inhibited by Noggin or LDN193189. Instead, SB203580 partially blocked BMP2-induced β-catenin expression and cell differentiation. Taken together, these data suggest a possible mechanism by which the elevation of β-catenin resulting from BMP2 stimulation is mediated by the p38 MAPK pathway, which sheds light on the molecular mechanisms of BMP2-mediated pulp reparative dentin formation.

Comparative study of cultivation of hair follicle bulge stem cell / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The purpose was to compare two different ways of culturing hair follicle bulge stem cell: The defined keratinocyte-serum free medium (DK-SFM) method and the 3T3 feeder cell method.</p><p><b>METHODS</b>The morphological features of cultured bulge stem cells were investigated by inverted phase control microscopy. Immunostaining of stem cell marker cluster of differentiation 34 (CD34) and epithelial cell marker cytokeratin 19 (CK19) were performed to identify the bulge stem cell. The stemness of bulge stem cells was evaluated by colony forming efficiency (CFE) and proportion of CD34 positive cells by flow cytometry.</p><p><b>RESULTS</b>Hair follicle bulge stem cells could be successfully cultivated in vitro using two methods. They were both positive for CK19 and CD34. The colony forming efficiency of hair follicle stem cell cultured in DK-SFM and the 3T3 feeder cell was 69.4% and 62.2%, respectively. There was no significant difference in colony forming efficiency between these two methods (P > 0.05), while the CD34 positive cells proportion was higher in DK-SFM as 72.3% than the other as 34.7% (P < 0.05).</p><p><b>CONCLUSION</b>Two methods are applicable to culture bulge stem cells in vitro. The 3T3 feeder cell method is complicated and can propagate a lot bulge stem cells from hair follicle, while the DK-SFM method is easier to get pure bulge stem cell.</p>

Effects of different sterilization methods on the corrosion of dental fissure bur / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The purpose was to analyze the effects of three sterilization methods (dry heat sterilization, steam sterilization, chemical sterilization) on the corrosion of dental fissure burs.</p><p><b>METHODS</b>100 dental fissure burs were distributed to 10 groups. One was control, the burs in the other 9 groups were treated by dry heat sterilization, steam sterilization, chemical sterilization with 5, 10, 15 cycles respectively. Weight method, scanning electron microscope, micro-hardness measurement were used to analyze the corrosion of dental fissure burs.</p><p><b>RESULTS</b>The fissure burs gained their weight with cycles of sterilization. 5, 10, 15 cycles of dry heat sterilization, 10, 15 cycles of steam sterilization and 15 cycles of chemical sterilization, the weight of fissure burs were significantly increased (P < 0.05). Scanning electron microscope showed differences on the surfaces of dental fissure burs among the three sterilization groups. After sterilization, spot or partial erosion were seen on the surface of the burs. The steam sterilization groups showed the most evident changes, followed by chemical sterilization groups and dry heat sterilization groups. X-ray energy spectrometer showed the steam sterilization groups had the largest percentage of W, followed by dry heat sterilization groups, chemical sterilization groups and control group. Fe had the opposite trends. Micro-hardness reduced after sterilization. The reduction was most clear in steam sterilization group, followed by chemical sterilization and dry heat sterilization ( P< 0.05). The difference between 5 and 10 times of steam sterilization and 5, 10, 15 times of chemical sterilization were significant difference (P < 0.05). There was no significant difference between 5, 10, 15 times of dry heat sterilization (P > 0.05).</p><p><b>CONCLUSION</b>The corrosion is most severe in steamsterilization group, followed by chemical sterilization, dry heat sterilization. Dry heat sterilization shows less corrosion.</p>

Gamma knife for hypersecreting pituitary adenoma: analysis of 120 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To estimate the efficacy of Gamma knife radiosurgery (GKR) especially as a primary surgical treatment for hypersecreting pituitary adenoma.</p><p><b>METHODS</b>One hundred and twenty cases with hypersecreting pituitary adenoma had been treated by Gamma knife radiosurgery. The clinical date had been analysed retrospectively. The tumor margin was covered by an isodose ranging from 45% to 70%. The margin dose was 15 to 32 Gy (mean 28.5 Gy) and the maximum dose varied from 35 to 70 Gy (mean 45.5 Gy). The total number of isocenter was 165 (mean 1-3).</p><p><b>RESULTS</b>One hundred and eleven cases had been followed-up by hormone level, and 104 cases had been followed-up by image of MRI. The mean follow-up duration was 12-72 months (mean 36 months). The control rate of hormone level was 48.6%, the control rate of tumor growth was 96.2%, the incidence of hypopituitarism was in 2.7% and the incidence of tumor apoplexy was in 0.9% in followed-up cases.</p><p><b>CONCLUSIONS</b>As a primary surgical treatment for hypersecreting pituitary adenoma, GKR can be effective and safe in controlling tumor growth and inducing hormonal normalization.</p>

Stent Implantation for Teatment of Intracranial Wide-Necked Aneurysms: 12 Cases Report / 中国康复理论与实践

@#ObjectiveTo investigate the effect of endovascular stent with or without coil graft on intracranial wide-necked aneurysms. Methods12 cases with intracranial wide-necked aneurysms, among whom, 10 cases were treated with stents and coils, 2 C4 aneurysms were treated with graft stent, were analyzed retrospectively. ResultsOf the 10 cases who were treated with stents and coils, 8 patients were completely occluded and other 2 patients were incompletely (>95%) occluded. 2 cases accepted graft stent were obliterated. Follow-up with angiography in 10 patients for 3～12 months revealed that all the aneurysms were completely occluded. 1 patient among them died. ConclusionEndovascular stent with or without coil graft is effective on intracranial wide-necked aneurysms.

Vasospasm after subarachnoid hemorrhage:diagnosis with MR angiography and CT angiography / 中国基层医药

Objective To evaluate the efficacy of MR angiogrphy(MRA) for detecting cerebral vasospasm after subarachnoid hemorrage(SAH) and compare it with spiral CT angiography(CTA).Methods Ten patients with SAH under MRA and CTA studies were performed within 24 hours after MRA,which was performed 5 to 10 days after SAH.Maximum intensity projection(MIP) images were produced for MRA and CTA studies.Five arterial locations were examined for spasm:the suprasellar internal carotid artery(ICA),the M1 and M2 segments of the middle cerebral artery(MCA),the A1 and A2 segments of the anterior cerebral artery(ACA).Vasospasm was cate- gorized as none,mild(50 % reduction).Results The overall correlation between MRA and CTA was 82 %(r=0.76),but it was better for proximal than distal lo- cations vessels.Agreement between MRA and CTA was greater for no spasm(89%) and severe spasm(100%)(r= 0.85～0.91)than for mild(56%)or moderate(67%)spasm(r=0.21～0.51).Conclusion MRA is highly accu- rate in the detecting no spasm or severe cerebral vasospasm in proximal arterial locations vessels;it is less accurate in detecting mild and moderate spasm in distal locations vessels.

Study on Serum Leptin,Insulin Like Growth Factor-1,Interleukin-6 and Tumor Necrosis Factor-Alpha Levels of Newborn Infants with Hypoxic-Ischemic Encephalopathy / 实用儿科临床杂志

Objective To determine levels of serum Leptin,insulin like growth factor-1(IGF-1),interleukin-6(IL-6) and tumor necrosis factor-alpha(TNF-?) in newborn infants with hypoxic-ischemic encephalopathy(HIE).Methods The asphyxiated and normal term neonates were included.The HIE group contained 45 cases and control group 20 cases.Serum Leptin,IGF-1,IL-6 and TNF-? levels were measured by a sensitive enzyme-linked immunosorbent assay.Results In asphyxiated term neonates,serum Leptin,IGF-1,IL-6 and TNF-? levels were significantly higher or lower than those in control group(all P