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Objective To compare the clinical efficacy of different treatments for injuries of medial collateral ligament (MCL) Ⅲgrade and anterior cruciate ligament (ACL). Methods Forty-six patients with MCLⅢgrade and ACL injuries admitted to Dalian Central Hospital from June 2013 to April 2017 were retrospectively analyzed, including 28 males and 18 females. Sixteen patients underwent arthroscopic reconstruction of the ACL, and medial collateral ligament was repaired with two anchors simultaneously in 2 weeks (group A); 15 patients were treated with reconstruction of the ACL in 2 weeks, and 4 times extracorporeal shock wave therapies were performed 2 weeks after surgery (group B); 15 patients were treated with reconstruction of the ACL in 2 weeks, and fixed with external fixation (group C). Patients were assessed in 3 months, 6 months and 12 months after surgery, and the Lysholm knee function score, the international knee documentation committee knee evaluation form (IKDC) score and the knee joint range of motion (ROM) were recorded. Results Three months after operation, the levels of Lysholm scores, IKDC scores and ROM in three groups were significantly improved compared with those before operation (P < 0.05). The IKDC scores and Lysholm scores in both group A and group B [IKDC score: (51.8 ± 3.1), (49.7 ± 3.9) scores; Lysholm score: (70.3 ± 3.7), (69.5 ± 3.4) scores] were better than those in group C [(44.5 ± 3.4), (59.3 ± 4.7) scores], and there were significant differences (P<0.05). Six months and 12 months after operation, the IKDC score, Lysholm score and the knee joint ROM in group A were better than those in group B and group C (P<0.05). Conclusions For knee joint MCLⅢgrade combined with ACL injuries, surgical treatment will obtain better functional scores and activity, and the effect of conservative treatment of MCL injury with extracorporeal shock wave therapy is not good.
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Objective To compare the therapeutic effect between Kirschner wire- loop plating and clavicular hook plate in the treatment of distal clavicle fractures. Methods Forty- two patients with type Neer Ⅱ distal clavicle fracture were selected, among whom 23 patients were treated with Kirschner wire- loop plating (group A), and 19 patients were treated with clavicular hook plate (group B). The operative time, fluoroscopy time, length of incision, intra- operative bleeding volume and hospitalization time etc were recorded. The patients were followed up at 6 weeks, 3 months, 6 months and 12 months after operation. The American shoulder and elbow society (ASES) score was evaluated, and the therapeutic effect was evaluated by Karlsson standard. Results The operative time and fluoroscopy time in group B were significantly lower than those in group A: (63.5 ± 12.4) min vs. (71.5 ± 11.1) min and (3.6 ± 1.9) s vs. (4.8 ± 1.5) s, but the intra- operative bleeding volume, length of incision and cases of postoperative shoulder pain in group A were significantly lower than those in group B:(91.5 ± 18.5) ml vs. (108.7 ± 32.5) ml, (6.6 ± 0.7) cm vs. (11.3 ± 0.9) cm and 2 cases vs. 14 cases, and there were statistical differences (P0.05). There was no statistical difference in ASES score at 6 weeks and 3 months after operation between 2 groups (P>0.05); but the ASES score at 6 and 12 months in group A was significantly higher than that in group B: (89.9 ± 12.6) scores vs. (79.7 ± 12.6) scores and (96.1 ± 4.8) scores vs. (86.1 ± 12.4) scores, and there was statistical difference (P0.05);but the cases of good and excellent at 12 months in group A was significantly more than that in group B:23 cases vs. 13 cases, and there was statistical difference (P<0.05). Conclusions Kirschner wire- loop plating provides a new treatment option for type Neer Ⅱ distal clavicle fractures. It is conducive to decrease the incidence of shoulder pain and improve the range of motion of should joint. Besides, this technology has advantage of small incision, relatively simple operation steps and small damage to the surrounding soft tissues of the acromioclavicular joint. It may be superior to the clavicular hook plate.
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Aim To investigate the pharmacodynamic experiment and molecular mechanisms of a diterpenoid from cortex pseudolaricis, pseudolaric acid B ( PB ) , on immunoregulation. Methods The mouse models of contact hypersensitivity ( CHS) were induced by 2,4-dinitrofluorobenzene ( DNFB ) . Then , the ear swelling and spleen index were measured after administered o-rally with PB. The pathological changes such as in-flammatory cell infiltration in ear skin were observed by hematoxylin and eosin ( HE ) staining. Besides, the expression of peroxisome proliferater-activated receptorγ ( PPARγ) and the phosphorylation of Akt were ana-lyzed by Western blot. The activity of PPARγ was fur-ther detected by luciferase reporter gene assay. Results The results showed that PB could both alleviate the ear thickness, inhibit the spleen index, and reduce the inflammatory degree of their ear skin, which might be involved in inducing PPARγexpression and activation, associated with suppressing Akt signaling pathway. Conclusion It is suggested that PB might regulate PPARγ-related Akt pathway, which indicates the pos-sibility of developing PB as a novel immunoregulation agent for treating inflammatory-immune disease.