Double-pulley combined with suture bridge technique for fixation of comminuted fractures of distal patella pole / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of double pulley combined with suture bridge in the treatment of comminuted fracture of the lower pole of the patella.@*METHODS@#From January 2018 to June 2020, 15 patients with comminuted fracture of the lower pole of the patella were treated with double pulley and suture bridge technology, including 9 males and 6 females, aged 28 to 68 years old with an average of (42.4±9.6) years old. All patients had obvious knee joint pain and limited movement after injury. All knee joints were examined by X-ray and CT, which confirmed that they were all comminuted fractures at the lower level of the patella. After operation, X-ray films of the knee joint were taken regularly to understand the fracture healing, the Insall Salvati index was measure, the range of motion of the joint was recorded, and the function of the knee joint was evaluateed by the Bostman scoring system.@*RESULTS@#All the 15 patients were followed up for 7 to 24 months with an average of (11.4±4.2) months, and there was no obvious anterior knee pain. At the last follow-up, the knee joint range of motion of the affected limb was 105° to 140° with an average of (128.5±12.8) °, and the Insall Salvati index was 0.79 to 1.12 with an average of (0.92±0.18). The X-ray film showed that the patella was bone healing, and no anchor fell off, broken, or displaced fracture block was found. Bostman patellar fracture function score was 27.85±2.06, 13 cases were excellent, 2 cases were good.@*CONCLUSION@#Double pulley technique combined with suture bridge technique is reliable for reduction and fixation of comminuted fracture of the lower pole of patella, and patients can start functional exercise early after operation.

Transcriptome array screening and verification of oral leukoplakia carcinogenesis-related hypoxia-responsive gene and microRNA / 华西口腔医学杂志

OBJECTIVES@#To study the hypoxia response gene and microRNA (miRNA) expression profiles in the pathogenesis and progression of oral leukoplakia (OLK).@*METHODS@#Affymetrix GeneChip human transcriptome array 2.0 was used to detect the transcriptome of normal mucosa, low-risk OLK, high-risk OLK, and early squamous cell carcinoma (SCC). Gene ontology function analysis was used to screen genes and key miRNAs whose biological role is hypoxia response. Quantitative reverse transcription polymerase ch-ain reaction (qRT-PCR) was used to verify the expression of hypoxia response genes and miRNAs.@*RESULTS@#A total of 7 different genes of hypoxia response between normal mucosa and low-risk OLK, 10 genes between low-risk and high-risk OLK, and 21 genes between high-risk OLK and SCC were identified. The results of qRT-PCR showed that the expression of hypoxia-inducible factor 1α, chemokine cc-motif ligand 2, and matrix metalloproteinase 3 mRNA and miR-21 in normal mucosa, OLK, and SCC increased in a stepwise manner. The expression difference between OLK and SCC was statistically significant and consistent with the results of transcriptome array.@*CONCLUSIONS@#The hypoxia response gene and related miRNA play roles in the development and progression of OLK.

Locking plate percutaneous external fixation for the treatment of pediatric tibial fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore treatment effect of the locking plate percutaneous external fixation to tibial fractures.</p><p><b>METHODS</b>From July 2010 to February 2013, 8 cases with pediatric tibial fractures were treated by using unilateral locking plate percutaneous external fixation,including 6 males and 2 females with an average age of 7 years old ranging from 4 to 10. Among them, 5 cases were open fractures involving 1 case of Gustilo-Anderson type II, 3 cases of type III A, 1 case of type III B; and the other 3 cases were closed fractures involving 2 cases of AO type A3, 1 cases of type B2. The postoperative bone healing and gait impact were observed and the function was evaluated by Johner-Wruhs scores.</p><p><b>RESULTS</b>All fractures healed successfully without infection. The fracture healing time was from 3 to 6 months with an average of 3.9 months. The locking plate removal time was from 4 to 7 months with an average of 4.3 months. Among them, 7 cases were visually normal after walking with stand, 1 case of anterior tibial tendon defect affected gait. The results of Johner-Wruhs assessment were excellent in 7 cases, good in 1 case. No rub contralateral medial calf skin wounds occurenced.</p><p><b>CONCLUSION</b>The method is simple, stable and reliable. The fixation strength is suitable for children using locking plate percutaneous external fixation. The postoperative functional recovery was excellent and the walking gait was less affected. But the point of LCP pedicle screw should be carefully selected before installation with good skin coverage.</p>