Gradual traction-unlocking closed reduction technique for Tile C old pelvic fractures / 中华创伤骨科杂志

Objective:To explore the technical points and efficacy of gradual traction-unlocking closed reduction technique (GT-UCRT) for Tile C old pelvic fractures.Methods:From August 2012 to June 2021, 6 patients with Tile C old pelvic fracture were treated and followed up at Department of Orthopedics, The Fourth Medical Center, General Hospital of Chinese PLA. They were 4 males and 2 females with an age of (35.8±10.5) years. By Tile classification: 4 cases of type C1.2, 1 case of type C1.3, and 1 case of type C2; time from injury to surgery: 153.8 (64.3, 204.8) days. The 6 patients were treated with GT-UCRT. The time for gradual traction reduction, operation time, hospital stay, intraoperative blood loss and complications were recorded. The modified Matta score was used to evaluate the reduction quality of pelvic fractures, and the Majeed score was used to evaluate the pelvic function at the last follow-up.Results:The 6 patients were followed up for (40.3±22.9) months (from 12 to 72 months) after surgery. The time for gradual traction reduction was (26.7±4.6) days, operation time (119.2±4.6) minutes, hospital stay (11.5±2.9) days, and intraoperative blood loss (533.3±189.6) mL. By the modified Matta score, the pelvic reduction after surgery was rated as satisfactory in 5 cases and as unsatisfactory in 1 case. The length disparity between both lower limbs in the 6 patients was (6.9±1.6) cm before surgery and (1.0±0.4) cm immediately after surgery, showing a statistically significant difference ( t=11.135, P<0.001). One fracture healed 3 months after surgery and 5 fractures 6 months after surgery. The Majeed pelvic score at the last follow-up was (80.8±9.0) points for the 6 patients, yielding 2 excellent cases, 3 good cases and 1 fair case. Delayed wound healing was reported in 1 patient, calf intermuscular venous thrombosis in 2 cases, and emotional anxiety and sleep disorder in 1 patient. No new lumbosacral plexus injury was found in any patient. Conclusions:In the treatment of Tile C old pelvic fractures, since our self-designed GT-UCRT combines the advantages of Ilizarov technique and unlocking closed reduction technique, it can not only protect the lumbosacral plexus but also obtain satisfactory reduction of the fracture.

Early effectiveness of computer navigation system-assisted transiliac-transsacral screws placement for posterior pelvic ring injuries / 中国修复重建外科杂志

OBJECTIVE@#To investigate the early effectiveness of transiliac-transsacral screws internal fixation assisted by augmented reality navigation system HoloSight (hereinafter referred to as "computer navigation system") in the treatment of posterior pelvic ring injuries.@*METHODS@#A retrospective analysis was made in the 41 patients with posterior pelvic ring injuries who had been treated surgically with transiliac-transsacral screws between June 2022 and June 2023. The patients were divided into navigation group (18 cases, using computer navigation system to assist screw implantation) and freehand group (23 cases, using C-arm X-ray fluoroscopy to guide screw implantation) according to the different methods of transiliac-transsacral screws placement. There was no significant difference in gender, age, body mass index, causes of injuries, Tile classification of pelvic fracture, days from injury to operation, usage of unlocking closed reduction technique between the two groups ( P>0.05). The time of screw implantation, the fluoroscopy times, the guide wire adjustment times of each screw, and the incidence of complications were recorded and compared between the two groups. The position of the transiliac-transsacral screw was scanned by CT within 2 days after operation, and the position of the screw was classified according to Gras standard.@*RESULTS@#The operation was successfully completed in both groups. The time of screw implantation, the fluoroscopy times, and the guide wire adjustment times of each screw in the navigation group were significantly less than those in the freehand group ( P<0.05). There were 2 cases of incision infection in the freehand group, and the incision healed by first intention after active dressing change; there was no screw-related complication in the navigation group during operation and early period after operation; the difference in incidence of complications between the two groups (8.7% vs. 0) was not significant ( P=0.495). According to the Gras standard, the screw position of the navigation group was significantly better than that of the freehand group ( P<0.05).@*CONCLUSION@#Compared with the traditional freehand method, the computer navigation system assisted transiliac-transsacral screws internal fixation in the treatment of posterior pelvic ring injuries has advantages of improving the accuracy of screw implantation and reducing radiation damage and the time of screw implantation.

Cannulated screws with sutures for treatment of transverse patellar fractures / 中华创伤骨科杂志

Objective:To evaluate the clinical efficacy of cannulated screws with sutures in the treatment of patellar transverse fractures.Methods:A retrospective analysis was performed of the data of 70 patients with patellar transverse fracture who had been admitted to Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital from January 2017 to March 2021. According to the construction methods for the tension band, the patients were divided into 3 groups. In group A of 21 cases subjected to fixation with cannulated screws with sutures (Fiber-Tape), there were 8 males and 13 females with a median age of 55.0 (48.0, 65.0) years; in group B of 32 cases subjected to fixation with Kirschner wire tension band, there were 15 males and 17 females with a median age of 52.5 (41.5, 63.0) years; in group C of 17 cases subjected to fixation with Cable-Pin system, there were 5 males and 12 females with a median age of 55.0 (37.0, 65.0) years. The 3 groups were compared in terms of complications, secondary surgery (removal of internal fixation), operation time, intraoperative blood loss and knee function rated by the Lysholm and B?stman scores at the last follow-up.Results:There were no significant differences in the preoperative general data between the 3 groups, showing they were comparable ( P > 0.05). There was no significant difference in the operation time, intraoperative blood transfusion or follow-up time among the 3 groups ( P > 0.05). The incidence of soft tissue irritation [4.8% (1/21)] and the secondary operation rate [4.8% (1/21)] in group A were significantly lower than those in group B [43.8% (14/32) and 37.5% (12/32)] and group C [41.2% (7/17) and 35.3% (6/17)] ( P < 0.05), but there was no statistically significant difference between group B and group C ( P > 0.05). In groups A, B and C, respectively, the Lysholm knee score was 84.0 (69.0, 88.0), 89.0 (71.5, 95.0) and 82.0 (63.0, 90.0), and the B?stman knee score 26.0 (23.0, 28.0), 26.5 (24.0, 27.5) and 26.0 (22.0, 28.0), showing no significant difference ( P > 0.05). There was no significant difference either in the incidence of other complications among the 3 groups ( P > 0.05). Conclusion:In the treatment of patellar transverse fractures, compared with the Kirschner wire tension band and Cable-Pin system, cannulated screws with sutures (Fiber-Tape) may lead to a lower incidence of soft tissue irritation and a lower rate of secondary surgery, but no significant differences in operation time, intraoperative blood loss, other complications or postoperative functional scores.

Relation of ethanol treatment with dopaminergic system in rat brain / 解剖学报

Objective To study the effect of ethonal on the dopaminergic system by analyzing the altered expression of tyrosine hydroxylase (TH) and dopamine transporter (DAT) in the brain of ethanol-treated rats. Methods Sixty Wistar rats were selected and divided into control group and ethanol-treated group, 30 per group, the ethanol-treated rats were treated with 20% ethanol for 6 months. Immunohistochemistry, flow cytometry and Western blotting were used to analyze the altered expression of TH and DAT in the DA energic system in different brain regions of the ethanol treated rats. Results 1. Immunohistochemistry showed the mean gray value of TH in substantia nigra(SN)-ventrotegmental area (VTA), caudae putamen (Cpu) and nucleus accumbens (NACC), DAT in Cpu and NACC of the ethanol were smaller than those in control (P<0.05). 2. Flow cytometry showed the expression of TH in middle brain of the ethanol-treated rats increased significantly compared with the control(P<0.05). 3. Western blotting showed the ratio of IA of TH/β-actin and DAT/β-actin in different brain regions of the ethanol-treated rats were larger than those in control(P<0.05).Conclusion Ethanol treatment increases the expression of TH and DAT in rat brain.

Expression of serotonin transporters in postmortem brains of Parkinson's disease patients / 基础医学与临床

Objective To study serotonin transporters(SERT) in postmortem human brains of Parkinson's disease(PD).Methods Immunoautoradiography was used to show SERT distribution in postmortem PD brains.ResultsIn comparison with healthy group,SERT decreased in dorsal raphe nucleus,substantia nigra and striatum in PD brains.Quantitative analysis showed that 25.9%、31.1%、27.2% and 24.7% of labeling intensity of SERT decreased in putamen,caudate nucleus,substantia nigra and ventrotegmental area as compared with corresponding control respectively.Among the four regions studied of dorsal raphe nucleus,SERT labeling intensity significantly decreased by 38.9%,37.3%,16.5% and 37.0% of corresponding control respectively in ventral part,dorsal part,caudal part and interfascicular part.Median raphe nucleus did not show the decreased SERT labeling.ConclusionDecreased SERT expression in three regions of postmortem PD brains indicates that a dysfunction of serotonergic raphe system may contribute to the etiology of Parkinson's disease.

Altered expression of dopamine transporter in substantia nigra and striatum in postmortem human brain of Parkinson’s disease / 中华神经科杂志

Objective To study the altered expression of dopamine transporter (DAT) in substantia nigra and striatum in postmortem human brain of Parkinson’s disease (PD). Methods Immunoautoradiography was used to reveal DAT distribution in postmortem human brain. Results Strongly labeling signal of DAT was mainly found in the substantia nigra, the putamen and the caudate nucleus in controls. In contrast, it was drastically reduced in the putmen and the dorsolateral caudate nuclus in PD brains, but the ventromedial part of the caudate nucleus showed a significant sparing adjacent to the border of the lateral ventricle. In the substantia nigra, the ventral and the lateral parts of the substantia nigra showed an obvious decreasing of DAT and the reducing degree of DAT labeling signals in those regions is smaller than that in the putamen and the caudate nucleus. Quantitative analysis revealed that 90.9% and 66.7% of the labeling intensity of DAT were decreased in the putamen and the caudate nucleus as comparing with the corresponding controls respectively (P

Immunoautoradiographic studies on the distribution of dopamine transporter in diffrerent regions of postmortem human brain / 解放军医学杂志

Objective Immunoreactive intensity of dopamine transporter(DAT)was quantitatively analyzed in the different regions of postmortem human brain in order to provide evidence in selecting an appropriate reference region for neuroimaging in measurement of the altered DAT.Methods The brain tissue blocks taken from 8 male cadavers were paraffin-embedded and sectioned,and immunoautoradiography was used to display the difference of DAT immunoreactive intensity in the substantia nigra,putamen and caudate nucleus,cingulate cortex,frontal cortex,occipital cortex and cerebellar cortex.Results The highest DAT density was found mainly in the substantia nigra,caudate nucleus and putamen,while the lowest density was only seen in cerebellar cortex.Quantitative analysis revealed that the intensity of DAT immunoreactivity(DAT-IR)in cerebellar cortex was respectively 1/3.50,1/3.72,1/1.28 of that in frontal cortex,cingulate cortex and occipital cortex,and it was only 1/8.33,1/11.67,1/8.56 that of substantia nigra,caudate nucleus and putamen.Conclusions The cerebellar cortex has the lowest DAT as compared to other examined brain regions,and it can be used for a reference region in neuroimaging to detect altered DAT.