Inference on Injury Mechanism of Ankle Fracture by Lauge-Hansen Classification.

OBJECTIVES: To explore the injury mechanism of ankle fracture inferred by the Lauge-Hansen classification with the application of medical imageology and its application value in forensic medicine. METHODS: A total of 32 ankle fracture cases with known injury mechanism were collected from January 2013 to May 2018, which were identified in Yongkang Public Security Bureau, Zhejiang Province. The Lauge-Hansen classification of ankle fracture was performed by three forensic experts based on the data of X-ray and CT image. Fisher's exact test and Kappa consistency analysis were performed by SPSS 20.0 statistical software to compare the results of the Lauge-Hansen classification with the injury mechanism of ankle fracture obtained through the criminal evidence. RESULTS: In 32 cases, 84.4% （27/32） ankle fractures were classified according to the Lauge-Hansen classification based on medical imaging. The mechanism of ankle fracture identified by the Lauge-Hansen classification was consistent with that obtained through the criminal evidence. CONCLUSIONS: Based on medical imaging, the Lauge-Hansen classification can be well applied to infer the injury mechanism of ankle fracture in part cases, and provide objective evidence for the crime scene reconstruction of criminal cases.

Transplantation of Human umbilical cord mesenchymal stem cells promotes functional recovery after spinal cord injury by blocking the expression of IL-7.

OBJECTIVE: This research aimed to investigate the therapeutic effects of transplanted human umbilical cord mesenchymal stem cells (hUCMSCs) on spinal cord injury in mice and to explore its molecular mechanism. MATERIALS AND METHODS: Spinal cord injury model in C57BL/6J mice was established. On the 10th day of SCI, hUCMSCs were injected into the center of spinal cord injury area (hUCMSC), and control groups (Control) were injected with an equal amount of medium. Western blotting, Real Time-PCR, immunohistochemistry, and flow cytometry, were used to analyze the content of IL-7, inflammatory cytokines, and macrophages after spinal cord injury in different groups. Open field and Rota-Rod tests were used to determine the effect of hUCMSC transplantation on motor function recovery in SCI mice. RESULTS: Compared with the control mice, hUCMSC transplantation therapy significantly improved the motor function, myelin, and nerve cell survival in spinal cord injury site in SCI mice. It also reduced the expression of IL-7, IFN-γ, and TNF-α in injured sites but increased IL-4 and IL-13 expression and promoted the activation of M2 macrophages at the site of injury. CONCLUSIONS: Transplantation of hUCMSCs in SCI mice can promote the polarization of M2 macrophages by reducing the expression of IL-7 in the injured site, thereby weakening the inflammatory response at the injured site, promoting the repair of the injured site and improving the motor function.

Craniocervical decompression with duraplasty and cerebellar tonsillectomy as treatment for Chiari malformation-I complicated with syringomyelia.

This study aimed to investigate the therapeutic effects of craniocervical decompression with duraplasty and cerebellar tonsillectomy for the treatment of Chiari malformation-I with syringomyelia (CM I-SM). From January 2005 to December 2011, 127 patients with CM I-SM underwent craniocervical decompression with duraplasty and cerebellar tonsillectomy and the therapeutic effects of these surgeries were evaluated using Tator scores. No patient in this study died or showed disease deterioration after the surgery. Re-examination by magnetic resonance imaging (MRI) showed that the cisterna magna was obviously larger after the operation in all but one patient. Moreover, syringomyelia (SM) was reduced in 76 patients. CM I-SM symptoms disappeared or decreased in 112 patients after following discharge. Follow-up was conducted in 84 of the patients and 79 of these patients exhibited improved symptoms. A second MRI re-examination showed that the cisterna magna was successfully constructed in 44 patients; 42 of these patients showed further eliminated or obviously reduced SM. Craniocervical decompression with duraplasty and cerebellar tonsillectomy achieved favorable therapeutic effects. Thus, craniocervical decompression with duraplasty and cerebellar tonsillectomy is a rational surgical approach with beneficial clinical effects. The proposed approach may have useful applications in the treatment of CM I-SM.