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BACKGROUND:Talus cartilage injury is a common motor system disease.This type of injury will affect the patient's daily life and work ability,and may worsen the condition if left untreated.Surgical treatment is commonly used,but the selection of surgical methods and the evaluation of medium-and long-term follow-up results have always been difficult clinical problems. OBJECTIVE:To explore the influence of T1ρ technique on the range of quantitative evaluation of talus osteochondral injury on the choice of surgical method and the results of medium-and long-term follow-up. METHODS:A total of 154 patients with osteochondral injury of talus admitted to The Second Hospital of Tangshan from January 2019 to August 2022 were retrospectively selected as the study subjects.The lesion site of talus was examined by MRI before operation,and the T1ρ and T2 values of different types were compared.Different surgical methods were selected according to the different T1ρ values.Group A(n=73)was treated with microfracture surgery with T1ρ<45 ms;group B(n=81)was treated with autogenous bone and cartilage transplantation with T1ρ≥45 ms.The general clinical characteristics and curative effects of patients under different surgical methods were compared;the important factors of postoperative recurrence were analyzed by multivariate Logistic regression,and the relationship between T1ρ value and postoperative recurrence was analyzed by restricted cubic spline graph,y=1-1/(1+e-z)regression equation to build a prediction model.The stability of the model was verified by cross-checking method. RESULTS AND CONCLUSION:(1)Classification of talus osteochondral injury in 154 patients(type Ⅰ:36 cases;type Ⅱ:37 cases;type Ⅲ:40 cases;type Ⅳ:41 cases),T1ρ and T2 values of the four groups were statistically significant(P<0.05);pairwise comparison was also statistically significant(all P<0.05).(2)After treatment of 154 patients,7 cases(4.6％)had local swelling,3 cases(2.0％)had pain aggravation,and 5 cases(3.3％)had wound infection.There were 2 cases(1.3％)with poor cartilage healing.(3)After treatment,there were statistically significant differences between groups A and B in terms of American Orthopaedic Foot&Ankle Society score,visual analog scale score,plantar flexor motion range,dorsoextension motion range,subchondral bone marrow edema volume,interleukin-6,interleukin-8,C-reactive protein,procalcitonin,platelet-derived growth factor,transforming growth factor-β1,and efficacy(P<0.05).The total effective rate of group B(90％)was higher than that of group A(85％)(P<0.05).(4)Age(OR=1.589,95％CI:0.305-1.252,P=0.036),interleukin-6(OR=1.737,95％CI:0.974-5.254,P=0.049),interleukin-8(OR=1.385,95％CI:1.066-4.355,P=0.034),C-reactive protein(OR=1.957,95％CI:1.323-2.178,P=0.035),transforming growth factor-β1(OR=1.459,95％CI:0.897-2.455,P=0.038),T1-ρ(OR=1.687,95％CI:0.854-3.321,P=0.026),T2(OR=1.843,95％CI:0.657-2.454,P=0.036),complications(OR=1.719,95％CI:0.654-3.464,P=0.019),and classification of osteochondral injury of talus(OR=3.789,95％CI:1.023-5.897,P=0.028)were independent risk factors for postoperative recurrence.Microfracture surgery(OR=0.751,95％CI:0.321-1.264,P=0.012)and autogenous bone and cartilage grafting(OR=0.649,95％CI:0.246-1.356,P=0.023)were independent protective factors for recurrence after medium-and long-term follow-up.(5)When T1ρ value≤35 ms,the risk of postoperative recurrence decreased rapidly,and when T1ρ value>35 ms,the risk of postoperative recurrence increased rapidly.(6)Further stepwise regression analysis showed that these nine risk factors were most closely associated with postoperative recurrence,and the formula for postoperative recurrence was obtained.The probability of postoperative recurrence was calculated using the regression equation.When P=0.75,the maximum value of Jorden index was 77.728,indicating that the model has a better prediction effect.(7)It is indicated that the quantitative evaluation of T1ρ before operation can effectively guide the selection of surgical methods,improve the success rate of surgery and the quality of life of patients.
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Objective:To analyse the material basis and potential mechanism of Acanthopanax senticosus injection (ASI) in the treatment of ischemic stroke by combining UPLC-Q/TOF-MS and network pharmacology.Methods:The chemical composition of ASI was identified by UPLC-Q/TOF-MS. The Swiss Target Prediction, GeneCards and OMIM databases were used to predict the potential targets for the action of ASI in the treatment of ischemic stroke. The String database and Cytoscape software were used to construct protein interaction network maps, and the Omicshare platform was used to perform gene ontology (GO) and KEGG enrichment analysis. The DockThor platform was used for molecular docking.Results:The analysis of 53 components in ASI was firmly established and used as a basis to obtain 189 related targets of ASI for the treatment of ischemic stroke. Reverse screening showed that 25 components in ASI may be important active components in the treatment of ischemic stroke. Functional enrichment studies found that ASI may mainly regulate PI3K-Akt signaling pathway to treat ischemic stroke.Conclusion:This study preliminarily predicted the mechanism of ASI in the treatment of ischemic stroke may be related to inhibition of inflammation, antioxidant stress, promotion of angiogenesis and protection of nerve cells.
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Objective To study the stability of Alprostadil Injection,and provide theoretical basis for its production,packaging,storage,and transportation conditions.Methods The contents of PGE1 and A1 in Alprostadil Injection were determined by HPLC method through strengthen test,accelerated test,and longterm test.The stability of Alprostadil Injection was investigated.Results Linearity,precision,stability,and recovery rate of E1 and A1 met the requirements;Placed for 10 d under high light and high temperature conditions,the color was obviously deepened,the pH value was almost unchanged,the content decreased significantly and degradation of related substances increased significantly;At 25 ℃ and after 6 months of acceleration test,the PH value decreased slightly and the content changed obviously.Three batches of samples were stored at 4℃ and long-term tested after 12 months,its appearance traits,related substances,and content of the indicators were in line with the relevant requirements.Conclusion Alprostadil Injection is unstable to light and heat,easy degradation,this product should be stored in dark and cold conditions,with the validity for one year.