Operation-effect analysis of 21 patients with ankle fracture and complete rupture of deltoid ligament / 中国骨伤

OBJECTIVE@#To explore short-term clinical effect of surgical treatment for ankle fracture with complete rupture of deltoid ligament in young and middle-aged patients.@*METHODS@#From January 2016 to March 2019, 21 young and middle-aged patients with ankle joint fracture and complete rupture of the deltoid ligament were treated with internal fixation and repair of the medial deltoid ligament, including 16 males and 5 females, aged from 21 to 52 years old with an average of (38.6±7.3) years old, the time from injury to operation ranged from 1 to 7 days with an average of (3.8±1.5) days. Fracture healing time and complications were observed, changes of medial malleolus clearance before and after operation were compared, American Orthopaedic Foot and Ankle Society (AOFAS) score wasused to evaluate function of ankle joint at 18 months after operation.@*RESULTS@#Twenty-one patients were followed up from 18 to 26 months with an average of (21.7±1.2) months. The incisions were healed at stageⅠ, and fracture healing time ranged from 8 to 12 weeks with an average of (9.5±1.6) weeks. No wound infection, failure of internal fixation, and nerve injury occurred. Medial malleoius space decreased from (5.83±0.32) mm before operation to (2.69±0.25) mm after operation. Postoperative AOFAS score at 18 months was 91.43±4.14, 14 patients got excellent results, 6 good and 1 fair.@*CONCLUSION@#On the basis of stable fixation of fracture, repair of deltoid ligament could help restoring the medial anatomy of ankle joint in young and middle-aged patients, and could achieve good short term clinical effect.

Treatment of Sanders type III fracture of the caIcaneus with poIymethyImethacryIate bone cement: a biomechanicaI study / 中国组织工程研究

BACKGROUND: Polymethylmethacrylate (PMMA), commonly known as bone cement, has been widely used in the orthopedic surgery. It ensures the immediate stability of prosthesis and the minimal micromotion at the cement-bone interface, allowing early weight-bearing after surgery. OBJECTIVE: To investigate the biomechanical performance of Sanders type III fracture of the calcaneus by using PMMA bone cement as a treatment. METHODS: Eight adult cadaveric ankle and calcaneus specimens were selected and served as normal controls after detection of biomechanical properties. Another eight specimens were collected and randomized into experimental group and control group to make a model of Sanders type III fracture in the calcaneus. In the experimental group, PMMA bone cement was injected into the defect area. In the control group, the artificial bone was implanted in the defect area and a steel plate was used to fix the lateral calcaneus. Biomechanical properties of the specimens in the experimental and control group were detected. RESULTS AND CONCLUSION: (1) Strain and stress of the calcaneus: The stress distribution of the calcaneus in the normal control group was consistent with that in the experimental group, and there was no significant difference between the two groups. The stress of the calcaneus in the experimental group was similar to that in the control group with no significant difference. (2) Displacement and axial stiffness of the calcaneus: Compared with the normal control group, the calcaneal displacement in the experimental group only decreased slightly, and there was no significant difference between the two groups, and likewise, the calcaneal displacement in the control group increased slightly. In the experimental group, the axial compression strength was (21.98±1.88) MPa and the axial compression stiffness was (1 633±150) N/mm. Therefore, there was no significant difference between the experimental group and the normal control group (P > 0.05). (3) Contact strength of the subtalar joint: Fractures basically recovered with good outcomes after PMMA bone cement injection. To conclude, by using PMMA bone cement in the treatment of calcaneus fractures, the scientific validity and clinical utility can be ensured.

Study on acupuncture parameters impacting on the acupuncture effect using cluster analysis in a rat model with middle cerebral artery occlusion / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the influence of acupuncture parameters on the acupuncture effect through the cluster analysis in Wistar rat model with middle cerebral artery occlusion (MCAO).</p><p><b>METHODS</b>Duplicated MCAO models by Zea-longa's thread ligation and chose rats with 1-3 scores assessed by Zausinger's six-score method to be grouped. The rats were divided into 6 basic control groups [(including a normal group, a sham group, a model control group, a model group without intervention, a Nimodipine group, a lateral-to-Renzhong (DU6) group] and 6 acupuncture groups [a Neiguan (PC6) group, a Weizhong (BL40) group, a Sanyinjiao (SP6) group, a Chize (LU5) group, a Renzhong (DU6) group and a Feixue (non-acupoint) group]. In the acupuncture groups, for every acupoint or needling site, 9 different parameters [2 factors (frequency and time) and 3 levels (180, 120, and 60 cpm of the frequency and 5, 60, and 180 s of the time)] were set respectively by the orthogonal intersection method, in total 54 groups. The rats were treated by acupuncture with a lifting-thrusting manipulation once every 12 h, in total 6 times. Neurobehavioral scores, cerebral blood flow, infarction rate, microcirculation, light microscopy, etc. were measured. The factor analysis was first applied to get the comprehensive effect scores of the samples in the acupuncture groups and then by which the cluster analysis was made with the statistical software of SPSS17.0.</p><p><b>RESULTS</b>For the Neiguan (PC6) group, the exceptional results of acupuncture comprehensive effect were parameters 7, 8, 9, 10; the valid results were parameters 2, 3, 4, and the invalid were parameters 5, 6. For the Weizhong (BL40) group, the exceptional results were parameters 2, 4; the valid results were parameters 3, 5, 6, 7, and the invalid were parameters 8, 9, 10. For the Chize (LU5) group, the exceptional results were parameters 7, 8; the valid results were parameters 3, 4, 5, 6, 9, 10; and the invalid was parameter 2. For the Sanyinjiao (SP6) group, the exceptional results were parameters 4, 6; the valid results were parameters 2, 3, 5; and the invalid were parameters 7, 8, 9,10. For the Renzhong (DU6) group, the exceptional results were parameters 3, 4, 6, 7, 9, 10; the valid results were parameters 2, 5; and the invalid was parameter 8. For the Non-acupoint group, the exceptional result was parameter 10; the valid results were parameters 2, 3, 4, 7, 9; and the invalid were parameters 5, 6, 8.</p><p><b>CONCLUSIONS</b>For each meridian acupoint, different acupuncture parameters could consequently get a different acupuncture effect; each meridian acupoint had the most suitable or optimal acupuncture parameters; acupuncture parameters might be the main factors impacting on acupuncture effect.</p>

Cluster analysis for acupoint specificity of acupuncture effect based on cerebral infarction rat model / 中国结合医学杂志

<p><b>OBJECTIVES</b>To study the acupoint specificity through the comprehensive evaluation of the acupuncture effect on rat model with the middle cerebral artery occlusion (MCAO).</p><p><b>METHODS</b>Duplicated MCAO model by Zea-longa's thread ligation was assessed by Zausinger's six-point method, and rats with 1-3 scores were chosen to be grouped. According to the randomized and controlled principle, rats were divided into 6 basic control groups (including normal group, sham group, model control group, model group without intervention, Nimodipine group, lateral-to-Renzhong group) and 6 acupuncture groups [including Neiguan (PC6) group, Weizhong (BL40) group, Chize (LU5) group, Sanyinjiao (SP6) group, Renzhong (DU6) group and non-acupoint group]; in each acupoint or non-acupoint 9 different parameter combinations were respectively set by orthogonal intersection method. There were in total 60 groups, and each group had 12 rats. The rats were treated by acupuncture with the lifting-thrusting manipulation every 12 h, in total 6 times. Indices of neurobehavioral scores, cerebral blood flow, infarction rate, microcirculation, and light microscope, etc. were measured. In order to comprehensively evaluate the acupuncture effect to research the specificity of acupoint, a cluster analysis was made with SPSS17.0 for the comprehensive effect scores of the samples computed according to the comprehensive evaluation models, and then sorting and classification were made for the comprehensive effect scores.</p><p><b>RESULTS</b>In the acupuncture groups every acupoint had different therapeutic effect due to different acupuncture parameter combinations; among the acupuncture groups the orders of curative effect were as followings: Neiguan group was of exceptional result, Weizhong group and Sanyinjiao group were of valid results in upper level, Chize group and Renzhong group were of valid results in lower level, and non-acupoint group was of invalid result; the therapeutic result of acupoint group was superior to non-acupoint group; and the curative effect of acupuncture group was also superior to basic control group.</p><p><b>CONCLUSION</b>The acupoint has the specificity of acupuncture effect, and the acupoint specificity is relative.</p>