[Application of pueumatic tourniquet in the operation of lower tibiofibular fracture].

OBJECTIVE: To investigate the complications of tourniquet in the clinical application of lower tibiofibular fracture. METHODS: From June 2018 to September 2019, 33 cases of closed lower tibiofibular fractures (AO type 43A) were treated with plates and screws and were divided into two groups according to whether pueumatic tourniquet was used:16 cases in the observation group, 13 males and 3 females, aged 18 to 69 (38.8±17.0) years, the operation time after injury was (6.9±1.7) days, and tourniquet was not used during operation. There were 17 cases in the control group, 13 males and 4 females, aged from 21 to 71 (43.8±12.4) years, the operation time after injury was (6.5±1.0) days, automatic pneumatic tourniquetwas routinely used in the operation. The operation time, blood loss, postoperative swelling, pain and other complications were compared between two groups. RESULTS: Total of 33 patients were followed up for an average of 15 months. There was no significant difference in operation time and blood loss between two groups (P>0.05). The VAS scores of limb pain in the observation group were 5.13±1.70 and 2.25±1.60 respectively 1 and 3 days after operation, which were significantly lower than those in the control group 7.35±1.30 and 4.18±1.60;the swelling was (3.67±0.70) cm and (2.02±0.90) cm respectively, which was significantly lower than(4.54±0.40) cm and(3.54±0.40) cm in the control group (P<0.05);there were 1 case of tourniquet pain, 1 case of numbness, 1 case of blister and 1 case of poor wound healing in the control group, there were no such complications in the observation group (P<0.05). CONCLUSION: The fracture of lower tibiofibular segment is superficial and easy to be exposed and fixed during operation. In order to avoid tourniquet complications, it is not recommended to use air bag tourniquet routinely or minimize the application time of tourniquet.

Rational application of fructose-1,6-diphosphate: From the perspective of pharmacokinetics.

Fructose-1,6-diphosphate (FDP), a glycolytic metabolite, has been reported to protect susceptible organs during hypoxia or ischemia. However, there is paucity of human data on its pharmacokinetics after being exogenously administered. In the current study, the preliminary pharmacokinetics of FDP given orally to humans was investigated, and no typical peak was observed in the serum drug-time curve. Then, the pharmacokinetic studies were performed following multiple doses of FDP in rats, and the Caco-2 monolayer model was used to study the absorption of FDP in vitro. The results suggested that plasma FDP concentration was significantly increased after oral multiple doses of 180 mg kg(-1) but not 90 mg kg(-1) of FDP, and FDP was partly depleted during the absorption, which was supposed to be consumed by the intestinal epithelium cells. Thus, we conclude that a high dose of FDP should be orally administered in order to get an effective plasma level.