BACKGROUND:The treatment of limbs’ open fracture with severe soft tissue injury is very complicated. There are many wound exudates, high frequency of dressing change, and high infection rate. How to deal with the contradiction between wound treatment and fracture fixation is the considerable problem in clinical therapy. ＜br> OBJECTIVE:To explore the effect of external fixator combined with vacuum sealing drainage on limbs’ open fracture with severe soft tissue injuries. ＜br> METHODS:A total of 34 patients with limbs’ open fracture with severe soft tissue injuries were enrol ed in the First Affiliated Hospital, Xinxiang Medical Col ege from December 2009 to December 2010. There were 20 males and 14 females, with an average age of 36.6 years old. There were 10 cases of upper limb fracture and 24 cases of lower limb fracture. After debridement, cutaneous deficiency accounted for 1%to 6%of surface area. On the basis of external fixation, the wound received vacuum sealing drainage (treatment group;n=17) and conventional dressing (control group;n=17). According to limb swel ing and granulation growth, delayed suture, skin graft or flap to cover the wound were used. After treatment, infection rate of the wound and growth of granulation were observed. In accordance with wound healing and growth of granulation, curative effects were evaluated. ＜br> RESULTS AND CONCLUSION:In the treatment group, there were 11 cases of healing, 5 cases of effective effects, and 1 case of ineffective effect, with a total effective rate of 94%and the infection rate of about 15%. In the control group, there were 7 cases of healing, 6 cases of effective effects, and 4 cases of ineffective effects, with a total effective rate of 76%and the infection rate of about 40%. Significant differences in healing rate, total effective rate and infection rate were detected between the two groups (P＜0.05). The healing time of wound was 8.66-16.23 days in the treatment group and 15.68-22.36 days in the control group. The healing time was significantly shorter in the treatment group than in the control group (P＜0.05). It is thus clear that vacuum sealing drainage has obvious advantages in repair of limbs’ open fracture with severe soft tissue injury compared with the conventional dressing.

AIM:To detect the expression of miRNA-363 and SOX4 in osteosarcoma tissues and to investigate the effect of miRNA-363 on the viability and apoptosis of human osteosarcoma cell line MG-63.METHODS: Real-time PCR was used to detect the expression level and the relationship of miRNA-363 and SOX4 mRNA in the osteosarcoma tis-sues and the corresponding paratumorous tissues collected from 63 patients.The expression levels of miRNA-363 and SOX4 in osteosarcoma cell line MG-63 after transfected with miRNA-363 mimics were measured .The cell viability was measured by CCK-8 assay.Flow cytometry was used to monitor the changes of cell cycle and apoptosis .The changes of SOX4 and miRNA-363 expression levels in the MG-63 cells after transfection with SOX4 siRNA or pcDNA/SOX4 was detect by real-time PCR.RESULTS:The expressed level of miRNA-363 was lower , and the expression level of SOX 4 was higher in the osteosarcoma tissues than those in the adjacent normal tissues .A significantly negative correlation between the expression levels of miRNA-363 and SOX4 was observed .The expression of miRNA-363 in the MG-63 cells after transfection with miRNA-363 mimics was significantly up-regulated, while the expression of SOX4 in the MG-63 cells was significantly down-regulated , with significant difference as compared with the cells transfected with miRNA-NC and control cells .The viability of MG-63 cells was inhibited, the cell cycle was arrested in G0/G1 phase, and the cell apoptosis was increased by transfec-tion with miRNA-363 mimics.The relative protein expression levels of SOX 4 in SOX4 siRNA group and pcNDA/SOX4 group were significantly different from those in negative control group , but the relative expression levels of miRNA-363 had no significant difference .Over-expression of SOX4 restored the viability of the MG-63 cells reduced by miR-363.CON-CLUSION:The expression level of miRNA-363 is low in human osteosarcoma tissue .miRNA-363 may inhibits the viabili-ty of osteosarcoma cell line MG-63 and promotes cell apoptosis in vitro via inhibiting the SOX4 expression.

Objective To explore the risk factors for recurrence after unilateral biportal endoscopy in patients with lumbar disc herniation.Methods Clinical data of 156 patients with lumbar disc herniation were retrospectively analyzed.All the patients underwent unilateral biportal endoscopy treatment.Follow up for 2 years after surgery,and the recurrence rate of all patients was recorded.The clinical characteristics of patients in the recurrent and non recurrent groups were compared,the factors influencing postoperative recurrence were analyzed by multivariate Logistic regression.Results After a 2-year follow-up,a total of 22 patients experienced recurrence,with a recurrence rate of 14.10%(22/156).The results of multivariate Logistic analysis showed that,the age>60 years old,fiber ring break>5 mm,incomplete nucleus pulposus removal,and postoperative intervertebral motion>10 ° were independent risk factors for recurrence after unilateral biportal endoscopy in patients with lumbar disc herniation(P<0.05).Conclusion Age>60 years old,fiber ring break>5 mm,incomplete removal of the nucleus pulposus,and postoperative intervertebral motion>10 ° were independent risk factors for recurrence after unilateral biportal endoscopy in patients with lumbar disc herniation,and prevention should be strengthened.