Risk factors analysis of achilles tendon rupture in male by propensity score / 中国医师杂志

Objective:To investigate the risk factors of achilles tendon rupture in male patients and to verify them.Methods:Retrospective analysis was made on the medical records of male inpatients with achilles tendon rupture (242 cases in achilles tendon rupture group) and simple ankle joint injury (825 cases in control group) admitted to Qilu Hospital of Shandong University from May 2013 to June 2020. The tendency score matching method was used to balance the confounding factors at a ratio of 1∶1. After matching, 147 cases were in achilles tendon rupture group and 147 cases in control group. The baseline data and related indicators were compared before and after matching, and the risk factors of achilles tendon rupture were analyzed by constructing a multivariate logistic regression model.Results:The age, smoking rate, drinking rate, family history of hypertension and diabetes, previous history of hypertension, diabetes and coronary heart disease, and BMI of the achilles tendon rupture group before matching were significantly lower than those of the control group (all P<0.05). After matching, there was no significant difference in age, smoking proportion, drinking proportion, family history of hypertension, diabetes and coronary heart disease, previous history of hypertension, diabetes and coronary heart disease, and BMI between the two groups (all P>0.05). After matching, the levels of fasting uric acid (UA), cholesterol (TG) and triglyceride (TC) in achilles tendon rupture group were significantly higher than those in control group, and the differences were statistically significant (all P<0.05). Multivariate binary logistic regression analysis showed UA ( OR=1.006, 95% CI: 1.003-1.010, P<0.001), TC ( OR=2.462, 95% CI: 1.194-5.076, P=0.015) was an independent risk factor for achilles tendon rupture in male. Conclusions:Dyslipidemia and UA may be an independent risk factor for achilles tendon rupture in male.

Medium-term clinical effects of minimally invasive percutaneous plate osteosynthesis for type sander Ⅲ, Ⅳ calcaneal fractures / 中国医师杂志

Objective:To compare minimally invasive percutaneous plate osteosynthesis (MIPPO) and open reduction and internal fixation via traditional lateral L-type approach (ORIF-LA) in the therapeutic effects concerning reduction and calcaneal alignment for Sanders Ⅲ/Ⅳ calcaneal fractures.Methods:A retrospective analysis was conducted of the 105 patients with calcaneal fracture who had been treated at Department of Foot and Ankle Surgery, Qilu Hospital from 2014.1 to 2018.2. Of them, 50 were treated with MIPPO (group A) and the other 55 with ORIF-LA (group B). The X-ray lateral and axial films, three-dimensional computed tomography (CT) of the calcaneal were taken pre-operatively and post-operatively to evaluate the reduction and calcaneal alignment. The American Orthopedic Foot Ankle (AOFAS) Ankle-Hind Foot Scale and Foot Function Index-Verbal Rating Scales (FFI-5pt) were adopted to assess the therapeutic effects. The postoperative complications of the two groups were compared.Results:All patients were followed up for 20-36 months (mean 24 months). The length of hospital stay and incision in group A was shorter than that in group B ( t=-11.276, -25.965, P<0.001). In group A and group B, the correction degrees of B?hler angle and Gissane angle were (34.49±3.81)°, (35.12±3.77)° and (-20.62±9.86)°, (-20.94±8.38)°, respectively ( P>0.05). Posterior calcaneal articular surface defects or steps in group A and group B were 1.55(1.12, 2.00)mm and 1.20(1.03, 1.60)mm, indicating that there was no significant difference in the reconstruction ability between the two groups ( P>0.05). There was no significant difference in VAS pain score between the two groups at 3 months after operation ( P>0.05), but group A was significantly lower than group B at 3 days after operation ( P<0.001). There was no significant difference in AOFAS and FFI-5pt scores between the two groups at 18 months after operation ( P>0.05). The complications of group A (6.0% incision infection, 2.0% incision area sensory disturbance, 2.0% foot stiffness) were lower than those of group B (16.36% incision infection, 14.55% incision area sensory disturbance, 10.9% foot stiffness) ( P<0.05). Conclusions:Compared with ORIF-LA, the MIPPO shows promising results in terms of reduction capacity and safety. Use of the MIPPO technique minimized the risk of postoperative wound complications and achieved superior functional outcomes compared with standard locking plate fixation via the extended lateral approach. MIPPO can be used as a choice for the treatment of calcaneal fracture.

Elastic fixation with Tightrope system for inferior tibiofibular syndesmosis diastasis: a cadaveric study / 中华创伤骨科杂志

Objective:To study the performance of the elastic fixation with our self-designed Tightrope system for inferior tibiofibular syndesmosis (ITFS) diastasis.Methods:In this self-control study, 6 specimens of normal cadaveric ankle were used as a normal ITFS group while the models of the ITFS diastasis were constructed as a group of ITFS diastasis. On the models of ITFS diastasis, elastic fixation with transverse Tightrope system (transverse fixation group) or binding Tightrope system (binding fixation group) was applied. The reduction and stability of ITFS were compared between transverse fixation and binding fixation for ITFS diastasis in terms of ITFS parameters on X-Ray[tibiofibular clear space (TFCS) and medial clear space (MCS)] and on CT[inferior tibiofibular anterior clear space (ITFACS), inferior tibiofibular middle clear space (ITFMCS), inferior tibiofibular posterior clear space (ITFPCS), anterior inferior tibiofibular interval (AITFI) and fibular rotation (θfib)].Results:The transverse fixation with Tightrope system for ITFS diastasis on the models led to iatrogenic injury to the fibular and the ITFS interosseous ligaments and to the perforating peroneal artery, and malreduction as well while the binding fixation with Tightrope system caused no injury to the anterior or the posterior ITFS ligament or the superior peroneal retinaculum but fine reduction as well. In comparisons of TFCS, ankle MCS, ITFACS, ITFMCS and AITFI between the 4 groups, normal ITFS group<binding fixation group<transverse fixation group<ITFS diastasis group; in comparison of ITFPCS between the 4 groups, transverse fixation group<binding fixation group<normal ITFS group< ITFS diastasis group; in comparison of θfib between the 4 groups, normal ITFS group<binding fixation group< ITFS diastasis group< transverse fixation group. Significant differences were shown in all the pairwise comparisons ( P<0.05). Conclusion:The binding fixation with our self-designed Tightrope system may be superior to the transverse fixation in surgical approach and reduction and stability of ITFS.

Single-stage reconstruction of achilles tendon and overlying skin defect with peroneus brevis tendon transfer and peroneal tendofascial flap / 中华显微外科杂志

Objective To explore the efficacy of peroneus brevis tendon transfer and peroneal tendofascial flap for repairing achilles tendon and overlying skin defect.Methods From April,2004 to May,2015,5 cases of achilles tendon and overlying skin defect were treated with peroneus brevis tendon transfer and peroneal tendofascial flap.In these cases,the length of the achilles tendon defect was from 3.0 cm to 8.0 cm,and the size of skin defect ranged from 2.0 cm × 3.0 cm to 3.0 cm × 5.0 cm.Using peroneus brevis tendon to reconstruct achilles tendon defect,and covered with peroneal tendofascial flap,and then skin graft.One of them combined with the gastrocnemius tendon V-Y advancement to promote the reconstruction of achilles tendon longer defect.The patients were followed-up regularly,and evaluated by the American Society of Ankle Arrhythmia (AOFAS) ankle-hindfoot scoring system.ResultsAll operations were successful and the grafted skin survived.All cases were followed-up from 6 months to 10 years with an average of 5.2 years.At the time of last followed-up,all wounds healed well without re-infection and ulceration.Not foot varus deformity and the strongth was back to the level before the injury.AOFAS ankle-hindfoot score was increased from (50.44 ± 12.05)(preoperative) to (90.02 ± 6.55)(the last follow-up) (P＜0.05).Conclusion There were some advantages in the method of the treatment of achilles tendon and overlying skin defect by using peroneus brevis tendon transfer and peroneal tendofascial flap,such as easy to cut,small damage to the donor area,and no significant deformity to the receptor area,etc.It is a good way to repair achilles tendon and overlying skin defects.

Role of interleukin-4 in the development of periodontitis in mouse model / 中国病理生理杂志

AIM: The purpose of this study was to investigate the role of interleukin-4 (IL-4) in the development of periodontitis in mice by low dosage of Trichinella spiralis (T. spiralis) infection.METHODS: Twenty-seven male Kunming mice in specific pathogen free grade were randomly divided into three groups: (1) the normal control group;(2) the experimental periodontitis group, which was produced by ligature of braided silk around the first maxillary molar, and was inoculated with putative periodontopathic bacteria;(3) the periodontitis with T. spiralis infection group. The mice were sacrificed at the end of 1, 3 and 5 weeks. The probing depth (PD) was measured before the mice were euthanized. The histological change of periodontal tissues was observed under the microscope after the samples were stained with hematoxylin and eosin. Furthermore, the serum level of IL-4 was determined by ELISA. RESULTS: (1) The serum level of IL-4 in T. spiralis-infected group was significantly higher than that in experimental periodontitis group (P<0.01). (2) The PD in T. spiralis-infected group was significantly lower than that in experimental periodontitis group (P<0.01). (3) Only a mild inflammatory response was observed in T. spiralis-infected animals. CONCLUSION: T. spiralis infection upregulates IL-4 expression and attenuates periodontitis in mice.

The effects of intestinal nematode infection on experimental periodontitis in mice / 实用口腔医学杂志

Objective: To investigate the effect of polarizing the immune response toward the Th2 type, using intestinal nematode (Trichinella spiralis) infection, on subsequent experimental periodontitis. Methods:Thirty six SPF KM mice were randomly divided into three groups. Periodontitis group: experimental periodontitis was induced by wrapping a 5/0 silk ligature inoculated with putative periodontopathic bacteria around the first maxillary molar. Th2-polaried group: After the mice were infected with low dosage Trichinella spiralis, the experimental periodontitis model was established at that time as above. Mice were sacrificed at the end of 1, 4, 8, 12 weeks. The histological analysis of periodontal tissues was observed by microscope after the samples were stained with hematoxylin and eosin (H&E). The concentrations of IFN--y and IL-4 in mouse serum were determined by ELISA. Results; The results showed that compared with control group Th2-polaried mice had high levels of IL-4 prior nematode infection reduced the severity of periodontitis, and subsequent infection of the periodontium with oral pathogens developed minimal lesions. Few or no osteoclasts were detected in lesions of Th2-polaried group. Conclusion;These results indicate a protective role of nematode infection in Thl cell-driven periodontal damage and prompt consideration of a novel therapeutic strategy in periodontitis based on im-munological distraction.

Preparation of Growth Hormone-Chitosan-Alginate Microcapsules and the Release Profile / 医学研究杂志

Objective To study the preparation and the in vitro and in vivo release profile of GH-Chitosan-Alginate microcapsules.Methods GH-Chitosan-Alginate microcapsules were prepared through impulsive electrostatic technique.The interrelated factors influencing the diameter and sphericity were studied through orthogonal experiments,and finally the statistic analysis made sure the optimum conditions to prepare microspheres.The morphology and size of the microcapsules were observed,and the content,encapsulation efficiency and recovery efficiency of the microcapsules were measured.Moreover,their in vitro and in vivo release experiments were carried out.Results The results showed that the diameter of needle was the most significant factor to the diameter of microspheres.The optimum conditions for the least diameter of microspheres were 450?m diameter of needle,2cm from needle tips to the gelation surfaee,1.5% alginate concentration,8ml/h speed of flowing-liquid and metal containers.The microcapsules had good sphericity morphology and distribution.The size of the microcapsules was in the range of 10-25?m with an average size of 47.93?m.The encapsulation efficiency and GH-load of the microcapsules were 94% and 11.24% respectively.The release kinetics of microcapsules was studied in false gastric and intestines juice.In false gastric juice,the GH of microcapsules was not released;in false intestines juice,it was released well,and TAM was completely released after about 12h.in vivo release profile made sure that the serum GH level of GH microcapsule group was at the highest value(98.59ng/ml) at 8h.The release profile was fitted well in both in vitro and in vivo conditions.Conclusion GH-Chitosan-Alginate Microcapsules have good morphology and sustained release effect.