Comparison between tension band and cerclage with X-Plate and lag screws in treatment of comminuted patellar fractures.

BACKGROUND: Comminuted patellar fractures are not rare, and the ideal treatment method remains controversial. The present study was conducted to evaluate effects and compare complications of two different methods used to treat comminuted patellar fractures. METHODS: From March 2010 to August 2016, 102 cases of 34-C2 or 34-C3 comminuted patellar fractures were treated at our hospital, wherein patients received two different treatments: titanium cable tension band with cerclage method (group A) and intrafragmentary screws with X-shaped plating technique (group B). At follow-ups, articular step-off, range of motion (ROM), Lysholm scores, time of union, and complications were recorded and analyzed. Radiographic and clinical data as well as rate of complications were statistically analyzed. RESULTS: In total, 87 patients were included in the final analysis (n = 47 in group A and n = 40 in group B). No significant differences were noted in terms of cost of implant, age, gender, rate of 34-C3 fractures, rate of layered inferior pole fractures, postoperative articular step-off and union time. At 2-year follow-up, average Lysholm scores, ROM and rate of complications were (89.0 ± 4.5), (122°±12°) and (27.7%) in group A and (90.2 ± 3.9), (124°±11°) and (17.5%) in group B, respectively, with no significant differences (p > 0.05). The mean time of surgery in group B was shorter than that in group A with significant difference (p < 0.05). CONCLUSIONS: Treatment using the intrafragmentary screws and plate method for amenable comminuted patellar fractures achieved similar complication rate and favorable functional outcomes at the 2-year follow-up, which was comparable to the titanium cable tension band with cerclage method. Thus, the intrafragmentary screws and plate method is effective, safe and convenient for 34-C2/C3 comminuted patellar fractures, especially appropriate for patients with layered fragments.

Exploring the Pathological Role of Collagen in Paravertebral Muscle in the Progression of Idiopathic Scoliosis.

BACKGROUND: Paravertebral muscle (PVM) is considered as a contributing factor of idiopathic scoliosis (IS); collagen is crucial for maintaining the mechanical properties of PVM, but only a few researches have described this field. In this study, we observed the muscle stiffness of PVM and the curvature of the spine by adjusting the content of collagen in PVM of rats and explored the role of collagen in the progression of IS. METHODS: 32 female Sprague Dawley rats were randomly divided into four groups: neutralizing antibody (NA) group (group 1), normal control group (group 2), IS group (group 3), and IS with NA group (group 4). TGF-ß1 NA was injected into PVM in group 1 and group 4, while Normal saline in group 2 and group 3. The Cobb angle and muscle stiffness were measured before and after injection; the rats were sacrificed at one week after injection, and performed histological, Western Blot, and qRT-PCR examinations. RESULTS: X-rays showed that scoliosis occurred in group 1 and relieved in group 4. The stiffness of PVM was decreased significantly on the convex side in group 1, while on the concave side in group 4. The expression of TGF-ß1 and COL1 on the concave side in IS rats (group 3) was significantly increased than that in normal rats (group 2), the concentration of COL1 and COL3 in group 3 was significantly higher than that in group 2, and the addition of TGF-ß1 NA significantly downregulated COL1 and COL3 in group 1 and group 4. The concentration of COL1 in convex PVM was negatively related to Cobb angle in group 1 and group 2, and in concave PVM was positively related to Cobb angle in group 3 and group 4. However, no significant correlation was found between COL3 and Cobb angle in group 3 and group 4. CONCLUSIONS: Asymmetric biomechanical characteristics of PVM was an important etiological factor of IS, which was directly correlated with collagen, it could be adjusted by local intramuscular injecting of TGF-ß1 NA, and finally had an effect on the shape of the spine.

The Effect of Exhaustive Exercise on Plasma Metabolic Profiles of Male and Female Rats.

The objective of the study was to evaluate the alteration in biochemical composition and gender difference within exhaustive exercise in male and female rats using a metabolomics strategy. Sixty male and female rats were randomly assigned to control, exhaustive exercise and one-week recovery groups, respectively. The metabolic profiles of plasma were investigated by gas chromatograph-mass spectrometry (GC-MS) and data further underwent orthogonal partial least-squares (OPLS) analysis. The current study found that gender was a significant determinant of the effects of exhaustive exercise on the cortisol, blood urea nitrogen, creatine kinase, and the ratio of reduced glutathione to oxidized glutathione, whereas, no significant interaction effects between gender and exhaustive exercise were found on the levels of testosterone, malonaldehyde, reduced glutathione, oxidized glutathione and lactic dehydrogenase. In male rats, the altered metabolites within exhaustive exercise included increased tricarboxylic acid cycle intermediates (citric acid, fumaric acid, butanedioic acid), branch-chain amino acids (valine, leucine), fatty acids and metabolite (oleic acid, linoleic acid, 3-hydroxybutyric acid), phosphate and decreased glucose, lactic acid, serine, and glutamic acid. In female rats, the levels of fatty acids and metabolite (linoleic acid, oleic acid, arachidonic acid, 3-hydroxybutyric acid), amino acids (valine, leucine, glutamic acid, 5-oxo-proline, methionine, ornithine), other metabolites urea, myo-inositol and phosphate were increased. The results indicated that exhaustive exercise increased the rates of energy metabolism, glucose metabolism, amino acid catabolism and fatty acid metabolism in male rats, whereas, female rats showed an increased propensity to oxidize lipid and conserve carbohydrate and protein metabolism against physical stress. Disordered urea cycle and inositol metabolism also occurred in female rats with exhaustive exercise. Exhaustive exercise affected the balance of hormone adjustment and caused oxidative stress, subsequent cell membrane damage both in male and female rats. A significant gender-related difference in the metabolic profiles was also found between male and female rats within exhaustive exercise.

[Analysis on indications and dominant diseases of acupotomology].

To analyze the indications and dominant diseases of acupotomology by literature research. The findings reveal that the 64.4% of all literature focused on eight categories of diseases, including the third lumbar vertebrae transverse process syndrome, tendinitis stenosans, cervical spondylosis, heel pain, scapulohumeral periarthritis, external humeral epicondylitis, lumbar disc herniation and osteoarthritis. The 87.5% of all literature focus on diseases of chronic strain of movement system, cervical spondylosis, cervicogenic disease, lumbar disc herniation and osteoarthritis. The indications of acupotomology are various, but not evenly distributed; the dominant diseases are comparatively concentrated. The acupotomology has great potential to treat the indications and dominant diseases. Therefore, acupotomology should be promoted scientifically in the future.

[Effect of acupotomy lysis on serum matrix metalloproteinase (MMP)-3 and MMP-13 contents in osteoarthritis rabbits].

OBJECTIVE: To observe the effect of acupotomy lysis on serum matrix metalloproteinase (MMP)-3 and MMP-13 contents in osteoarthritis (OA) rabbits. METHODS: A total of 34 New Zealand rabbits were randomly divided into normal group (n = 7), model group (n = 7), acupotomy group (n = 10) and electroacupuncture (EA) group (n = 10). OA model was established by left-hindlimb-joint-immobilization method. Acupotomy lysis was applied to the affected joint, once a week for 3 weeks. EA (2/100 Hz, 2 mA) was applied to "Yinlingquan" (SP 9), "Yanglingquan" (GB 34) and "Liangqiu" (ST 34) on the left hindlimb for 10 min, 3 times a week for 3 weeks. Serum MMP-3 and MMP-13 contents were detected with enzyme linked immunosorbent assay (ELISA) method. RESULTS: In comparison with model group (grade III: 1 case; grade: 4 cases), the left knee-joint-motion range of rabbits in acupotomy and EA groups (grade I: 1 and 1 case; grade II: 4 and 3 cases; grade III: 2 and 2 cases; grade IV: 1 and 2 cases separately) increased significantly (P < 0.05). Compared with normal group, serum MMP-3 and MMP-13 contents in model group increased significantly (P < 0.05); while compared with model group, both MMP-3 and MMP-13 levels of acupotomy and EA groups reduced considerably (P < 0.05). No obvious difference was found between acupotomy and EA groups in the left knee-joint motion range, and serum MMP-3 and MMP-13 levels (P > 0.05). CONCLUSION: Acupotomy is effective in lowering serum MMP-3 and MMP-13 levels, and in improving OA rabbits' knee-joint motion range.

[Advances of studies on acupuncture reinforcing-reducing of twirling-rotating the needle].

The theories and clinical and experimental studies about reinforcing-reducing manipulation of twirling rotating the needle in recent 15 years are reviewed and a brief account of manipulation methods, mechanisms and effects of reinforcing-reducing manipulation of twirling-rotating the needle is given, and it is indicated that the following several aspects in the studies at present need to be completed. Standardization and establishment of national standard of acupuncture manipulation must be enforced; quantitative parameters of acupuncture manipulation and mechanisms of acupuncture reinforcing-reducing of twirling-rotating the needle need to be further studied.

[Effects of needle knife relaxing therapy on tension of local soft tissue and pain of osteoarthritis of knee].

OBJECTIVE: To probe into the mechanism and methods of needle knife relaxing therapy for treatment of osteoarthritis of knee from biomechanical view. METHODS: Needle knife relaxing therapy was given to 92 pain points around the knee joint in 14 cases of osteoarthritis of knee, and the displacement of the local pain point under the stress of 500 g (L500 g) was measured and the VAS scores were recorded before and after treatment. RESULTS: L500 g of the pain point was (4.72+/-1.03) mm before treatment and (5.39+/-1.01) mm after treatment with a very significant difference before and after treatment (P<0.01), and VAS score was (7.10+/-1.49) points before treatment and (1.49+/-1.24) points after treatment with a very significant difference before and after treatment (P<0.01), and there was a linear correlation between the changes of L500 g and VAS scores. CONCLUSION: There was close connection between the local pain and tension of local soft tissue in knee osteoarthritis. The needle knife relaxing therapy can relieve the neurovascular compression or traction syndrome by relaxing the local contracted, adhesive soft tissue, so as to relieve tension pain and finally recover internal force equilibrium of the knee joint.