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Vascular cognitive impairment (VCI) is a clinical syndrome with impairment of at least one cognitive domain caused by vascular risk factors or cerebrovascular diseases, and its pathogenesis is not completely clear so far. Microglia are innate immune cells in the brain. They participate in many processes such as neuroinflammation, synaptic pruning, myelin regeneration, neurogenesis and connection. They are associated with the occurrence and development of various neurological diseases such as cerebral infarction, Alzheimer's disease, Parkinson's disease, and autism. Recent studies have shown that microglia play an important role in the development of VCI. This article reviews the role of microglia in VCI.
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Objective To compare percutaneous suturing with sponge forceps and open suturing for repair of acute closed Achilles ruptures.Methods From March 2011 to June 2014,40 patients with acute closed Achilles rupture were enrolled in this study and randomized into 2 equal groups (n =20) which were subjected to percutaneous suturing with sponge forceps or open suturing.The operative time,incisive length,blood loss,wound healing,hospitalization time and complications were compared between the 2 groups.Their ankle functions were evaluated at postoperative 3,6,and 12 months according to American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores.Results The operative time (median,60.0 min),hospitalization time (median,8.5 d) and incisive length (median,8.0 cm) in the open suturing group were significantly greater than those in the sponge forceps group (32.5 min,7.0 d and 1.5 cm) (P ＜ 0.05).The blood loss (15.1 ± 13.7 mL) in the sponge forceps group was significantly less than in the open suturing group (54.2 ± 33.9 mL) (P ＜ 0.05).The open suturing group received an average follow-up of 16.8 months (from 12 to 23 months),witnessed superficial skin infection in 3 cases,and obtained AOFAS scores of 91.2 ± 5.1,95.2 ± 2.8 and 97.8 ± 1.6 at 3,6,and 12 months postoperatively.The sponge forceps group received an average follow-up of 15.6 months (from 12 to 24 months),witnessed wound healing in all cases,and obtained AOFAS scores of 90.6 ±5.3,94.I ±2.6 and 97.0 ±2.6 at 3,6,and 12 months postoperatively.The sponge forceps group obtained insignificantly lower AOFAS scores than the open suturing group (P ＞ 0.05).No injury to the sural nerve or tendon rerupture happened in either group.Conclusions In treatment of acute closed Achilles ruptures,compared with open suturing,percutaneous suturing with sponge forceps may be relatively easier without using special equipment,and additionally,may lead to lower incidence of incision complications and better short-term efficacy.
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Objective To evaluate the clinical effects of the Masquelet technique combined with antibiotic calcium sulfate pellets in treating infected bone defects.Methods From February 2014 to February 2016,9 patients with infected bone defects were treated in our department,including 7 males and 2 females,with an average age of 37.0 years (range,24-56 years).6 cases were infected because of open fractures,3 infected after internal fixation operation.All defects were located in the lower limb diaphysis and metaphysis (3 cases in femur,6 cases in tibia).The length of the bone defects were 4-12 cm after debridement,all defects filled with PMMA loaded with Vancomycin,and fixed with exterual fixators.After 6-10 weeks,the bone cement spacers were taken out and the antibiotic calcium sulfate pellets were implanted into the membrane.A certain amount of autogenous cancellous bone granules would be mixed into the calcium sulfate pellets if the defect was larger than 6-8 cm.5 cases remained fixed with external fixators,3 cases replaced for plates,1 case replaced for plaster external fixator.Regular X-ray follow-ups were taken and complications recorded as well.Evaluate the healing of bone defect and functional recovery of adjacent joints by Samantha X score system,visual analogue scale (VAS) and Paley method,respectively.Results The 9 cases were followed up for a mean duration of 9.3 months (range,6-15 months).All bone defects healed after a mean time of 14 weeks (range,10-24 weeks).The wound poor healing occurred in only 1 case in the first stage of surgery,and cured by dressing changes.No complications of the recurrence of infection and implant failure.At the last follow-up,the average Samantha X score was 4.9,the VAS score was 0 to 3 (average 1.5) for patients standing on crutches and all the bone defect healing graded excellent evaluated by Paley method,the functional recovery of the adjacent joints graded:excellent in 6 cases,good in 2 cases,and fair in 1 case (the excellent and good rate was 89％).Conclusion Masquelet technique combined with antibiotic calcium sulfate particles is effective in the treatment of infected bone defects.
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Objective To verify BMP-2 and VEGF gene activated nanobone paste can effectively enhance the vertebral bone of ovariectomized goat.Methods From January,2011 to May,2016,the goats had been neutered by ovariectomy 6 months earlier to induceosteoporosis.Then surgery to established the model of vertebral bone defected with nanobone implanting,and the operation vertebrae divided randomly into 3 groups:control group,nanobone group and double gene activated nanobone group.Three months after operation the goats were sacrificed and removed the vertebrae.Micro CT analysis of micro three-dimensional structure of trabecular bone,scanning electron microscope (SEM) analysis of the two-dimensional structure of the vertebrae,the structure of trabecular bone was evaluated by movat pentachrome staining.Results The dual gene activated nanobone group compared with the nanobone group,the bone volume fraction (BV/TV) significantly increased (85％ at 1.2 mm vs 43％ at 1.2 mm,P ＜ 0.05);the dual gene activated nanobone group compared with nanobone group,in the largest ROI (1.2 mm),TbTh increased 10.9％ (374 ± 26.2 μm vs 337 ± 22.3 μm,P ＜ 0.05);Trabecular distribution coefficient (TbPf) was significantly decreased (7.519 ± 0.184 mm-1 vs 7.529 ± 0.261 mm-1,P ＜ 0.05);In the largest ROI (0.8 mm),trabecular distribution coefficient (TbPf) was significantly decreased (283 ± 36.4 μm vs 327 ± 31.2 μm,P ＜ 0.05),In the largest ROI (0.8 mm),the trabecular bone volume (Tbn) was increased 20％(1.404 ± 0.283 mm-1 vs 1.173 ± 0.224 mm-1,P ＜ 0.05);Cortical thickness over the implantation area showed asignificant increase of 43％ in vertebrae(P ＜ 0.05);The histological analysis revealed a more extensive osseointegration of the dual gene activated nanobone group,with the presence of anabundant osteoid tissue and an osteoblastic celllining.Conclusion BMP-2 and VEGF gene activated nano bone paste can effectively enhance the vertebral bone of ovariectomized goat.
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Objective To analyze the clinical feature and diagnostic methods of patients with ischemic colitis(IC) for improving the recognition and the efficacy of therapeutic treatment. Methods Retrospective analysis of the clinical data of 30 cases of IC,including the medical history,clinical symptomatology,endoscopic appearance, histopa-thology,treatment and prognosis. Results IC occurred most of frequently in mid-aged and elders,the male-female ra-tio was 1:2.3,83.3% of the patients were over 60 years old, and most them had underlying disease. The most com-mon presenting features were sudden abdominal pain and bloody stools. Endoscopic lesions located mainly in left co-lon. Mucosal edema,erosin and submucosal bleeding were common pathological feature. Vasodilator drugs and compre-hensive medical therapy had good effects. The average duration for healing or improving was 10 days. Conclusions IC should be suspected in all elder patients with sudden abdominal pain and bloody stools. Colonoscopy is helpful for diagnosis. The prognosis is good in most cases and with rapid recovery.