BACKGROUND:Distal radius C fractures belong to multiple fractures in the joint. Its treatment should recover various angles and joint surface continuity outside the joint. The recovery of palmar tilt angle, radial inclination angle and radial height is also very important for treating distal radius. OBJECTIVE:To study the changes in palmar tilt angle, radial inclination angle and radial height after type C fractures of the distal radius repaired with Acu-Loc(R)2 VDR bone plate system. METHODS:From May 2015 to March 2016, 11 cases of type C distal radial fractures were treated with Acu-Loc(R)2 VDR bone plate system. Preoperatively, the palmar tilt angle was-31° to-4° (-12.45° on average), and the radial inclination angle was 6° to 18° (11.18° on average), and the radial height was 1.92 mm to 8.68 mm (5.28 mm on average). X-ray films were observed at postoperative 4, 8 and 12 weeks and half a year in all patients. Palmar tilt angle, radial inclination angle and radial height were measured and observed using anteroposterior and lateral X-ray films during final follow-up. Wrist function was assessed with Gartland-Werley score. RESULTS AND CONCLUSION:(1) 11 patients were followed and the postoperative follow-up ranged from 7 months to 15 months. X-ray films showed that the union of fractures was achieved in 6-8 weeks (6.5 weeks on average). No infection or internal fixation failure occurred. The articular facets were smooth in 10 patients and a little poor was found in 1 case (<2 mm). (2) After operation, the palmar tilt angle was 8° to 15° (11.55° on average) (P<0.05);the radial inclination angle was 22° to 27° (23.18° on average) (P<0.05);the radial height was 8.01 mm to 13 mm (11.03 mm on average) (P<0.05). (3) The results were excellent in 8 cases, good in 2 cases, and poor in 1 cases according to Gartland-Werley wrist function assessment;the excellent and good rate was 91%. (4) Acu-Loc(R)2 VDR bone plate fixation can provide reliable fixation and effective support for type C distal radius fractures, which can recover the palmar tilt angle, the radial inclination angle and the radial height, so the Acu-Loc(R)2 VDR bone plate is an ideal method to treat type C fractures of the distal radius.

Total knee replacement surgery is commonly used in end-stage diseases of the knee. It is important for improving surgical efficacy and patient satisfaction by promoting early rehabilitation of patients and improving knee function.

Objective To screen the active components of Bushen Huoxue Decoction ( BSHXD) involved in promoting the proliferation of bone marrow mesenchymal stem cells ( MSCs). Methods BSHXD and its subdivisions were extracted with petroleum ether, ethyl acetate, water-free ethanol and water respectively. MSCs were isolated and cultured by the bone marrow adherent method. At the third passage, MSCs were identified by the specific surface markers with immunofluorescence, and their osteogenic and adipogenic differentiation were tested by alizarin red staining and oil red “O” staining. After treated with the extracts of BSHXD and its subdivisions at gradient concentrations for 24 hours, cell viability was detected by methyl thiazolyl tetrazolium (MTT) assay for the screening of active components and optimal concentration. MTT assay was used to describe the growth curve of MSCs treated with the most effective components, and cell cycle was analyzed by flow cytometry. Results Compared with the blank control group, the extracts of BSHXD and its subdivisions could protect MSCs from death to various degrees. Of all the extracts, the ethyl acetate extract of Bushen Division ( BSD) , ethyl acetate extract of BSHXD, ethyl acetate extract of Huoxue Division ( HXD) had the strongest effect, and the effect was dose-dependent, 100 μg/mL being the optimal active concentration while having no any cytotoxic reaction. The results of MTT assay revealed that BSD extracts promoted the proliferation of MSCs significantly and was the most effective component, and then came BSHXD. The results of flow cytometry indicated that BSD extract had the most strongest effect on increasing the amount of MSCs at proliferative phase, and then came BSHXD. Conclusion BSD ethyl acetate extract is the active component of BSHXD for promoting the proliferation of MSCs, showing an effect on increasing the proportion of MSCs at proliferative phase.