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Objective: To investigate the effectiveness of closed or limited open reduction and intramedullary nail fixation in the treatment of Seinsheimer type Ⅴ subtrochanteric fracture. Methods: Between May 2014 and July 2018, 36 patients with Scinsheimer type Ⅴ subtrochanteric fractures were treated with closed or limited open reduction and intramedullary nail fixation. There were 25 males and 11 females with an age of 23-86 years (mean, 55.8 years). The cause of injury included falling in 19 cases, traffic accident in 9 cases, falling from height in 7 cases, and heavy object injury in 1 case; all were fresh closed injuries. The interval between injury and operation was 1-14 days (mean, 6.8 days). There were 18 cases of closed reduction and 18 cases of limited open reduction during the operation. Seventeen cases were fixed with femoral reconstruction intramedullary nail, 5 with InterTan long nail, 14 with lengthened proximal femoral nail anti-rotation, and 7 cases were assisted with auxiliary steel wire binding. After operation, through X-ray film and clinical follow-up, the fracture reduction and maintenance status, internal fixation position, and fracture healing were judged; the range of motion, walking ability, and complications of hip joint were observed, and the function of hip joint was evaluated according to Merle d'Aubigne Postel hip joint scoring standard. Results: All the incisions of medullary operation healed by first intention, and no vascular, nerve injury, or infection occurred. All patients were followed up 12-24 months, with an average of 14.2 months. Among the 36 patients, 1 patient received revision surgery due to varus displacement of femoral head and screw penetration at 2 months after closed reduction, with poor recovery of hip function. X-ray film re-examination showed that the fractures of the other 35 patients healed after 9-15 months, with an average of 11.5 months. During follow-up, there was no complication such as internal fixation failure, fracture redisplacement, bone nonunion or malunion, and deep vein thrombosis of lower extremity occurred. The function of hip joint recovered well, and the patients could walk and squat normally without affecting daily life or work. At last follow-up, according to Merle d'Aubigne Postel hip joint scoring standard, 28 cases were rated as excellent, 4 cases as good, 3 cases as fair, and 1 case as poor, the excellent and good rate was 88.9%. Conclusion: C-arm X-ray fluoroscopic closed or limited open reduction and intramedullary nail fixation for the treatment of Seinheimer Ⅴ type subtrochanteric fracture, if necessary, with the aid of auxiliary steel wire binding, it has the advantages of less blood supply destruction at the fracture end, satisfactory reduction, firm fixation, and early rehabilitation training, with definite effectiveness.
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Forty-three patients with comminuted Craig type Ⅱand Ⅴ distal clavicle fractures were treated with clavicular hook locking plate and Kirschner wire from July 2013 to January 2015 in Tengzhou Central People's Hospital.Patients were followed up for 12-20 months with an average of 18 months.All fractures were clinically healed .In the 3 and 6 months after the operation, the Constant-Murley function score and the visual analogue score ( VAS) of the quality of life satisfaction were improved compared with those before operation (75.1 ±1.4 and 85.6 ±1.3 vs.44.3 ±1.8; 7.02 ±0.67 and 8.16 ±0.57 vs. 2.54 ±0.67, all P ＜0.05).There were no fracture delayed healing, nonunion, plate fracture and clavicular re-fracture among all patients .It is suggested that the curative effect of the clavicular hook locking plate combined with Kirschner wire is satisfactory and the bone healing rate is high for comminuted Craig type Ⅱ and Ⅴ type distal clavicle fractures.
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Objective @#To investigate the clinical efficacy of prosthesis retained by metal clasp and flexible clasp in the repair of type Ⅴ maxillary defects after tumor resection. @*Methods@#23 maxillary tumor surgical patients were selected in this study and restored with maxillofacial prosthesis. Total 24 prosthesis combined with metal clasp and flexible dentures were followed up for half a year to 2 years. @*Results @#After the application of prosthesis, better maxillofacial appearances are presented in all of the patients, Watian drinking water tests are improved to grade Ⅰ or Ⅱ from grade Ⅳ or Ⅴ in 21 patients, there was significant difference (P < 0.05); Soft diet can be masticated on affected side in 15 patients; The mean speech intelligibility score with and without prosthesis were (83.2 ± 7.3)% and (36.6 ± 5.6)%, there was significant difference (P < 0.05); Favorable hygienic situations of oral cavity and prosthesis are maintained in 18 patients.@*Conclusion @#Prosthesis combined with metal clasp and flexible denture performed favorable clinical efficacy and contributed to improve the living quality and mental health after tumor resection.
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AIM: To study the function of activin receptor-like kinase Ⅰ(ALK1) gene in vascular endothelium.METHODS: The human umbilical vein endothelial cells(HUVECs) were cultured,and the change of expression of ALK1,ALK5 in activation of HUVECs was analyzed.The full-leng coding sequence of ALK1 was cloned into pcDNA3.1+using standard protocols.The constructed pcDNA3.1+ALK1 plasmid were transfected into HUVECs.The proliferation and migration of HUVECs were detected by boyden champer and flow cytometry.RESULTS: The expression of ALK1 was up-regulated in resolution.ALK1 promoted the proliferation and migration of HUVECs.CONCLUSION: ALK1 has an important function in remodeling by promoting the proliferation and migration of endothelial cells.