Objective:To evaluate the treatment of pseudoarticular scaphoid nonunion with bone graft and percutaneous fixation under wrist arthroscopy.Methods:Six patients with pseudoarticular scaphoid nonunion were treated with arthroscopic debridement, bong grafting and percutaneous fixation between October 2015 and October 2018 at Department of Hand Surgery, Xuzhou Renci Hospital. They were 5 men and one woman with 4 left and 2 right sides affected, aged from 28 to 51 years (mean, 39.5 years). The sclerotic bone was erased under wrist arthroscopy. Percutaneous fixation started after autoallergic cancellous bone chips were implanted and impacted through a sleeve inserted via the medial carpal approach. For the nonunion with a pseudarthrosis connecting the midcarpal and radiocarpal joints, we put an inflated Foley catheter through a 3/4 portal underneath the proximal edge of the pseudarthrosis to block the possible leakage of the small cancellous bone chips. The wrist functions were evaluated at the final follow-up using the modified Mayo elbow performance score (MEPS); the flexion-extension motion and ulnar-radial deviation of the wrist were recorded.Results:The operation time for the 6 patients ranged from 2 to 4 hours (average, 3.2 hours); their follow-up duration ranged from 6 to 15 months (average, 11.3 months). All the patients obtained bony union after 8 to 14 weeks (average, 12.1 weeks). The flexion-extension motion of their affected wrist ranged from 75° to 135° (average, 107.0°), accounting for 85% of that of the healthy side; the ulnar-radial deviation of their affected wrist ranged from 40° to 80° (average, 51.5°), accounting for 88% of that of the healthy side. MEPS at the final follow-up revealed 4 excellent, one good and one fair cases.Conclusion:Arthroscopic bone grafting and percutaneous fixation is a reliable and effective minimally invasive treatment for pseudarthrotic scaphoid nonunions.

Objective To investigate the effects of different dialysates on expression of protein kinase C-δ (PKCδ) and apoptosis of U937 cell line. Methods Different dialysates were added into culture fluid with U937 cell line at exponential phase of growth, and groups were divided: fluid A+fluid B group (dialysate A+dialysate B), fluid A+fluid B+rottlerin (PKCδ specific inhibitor)group, fluid A+powder B group (dialysate A+powder B) and fluid A+powder B + rottlerin group. Besides, blank control group and normal control group were established. Cells were harvested 24 h and 48 h after treatment, morphological changes were observed by Hoechst33258 fluorescence staining, cell apoptosis was measured by Annexin-V-FITC/PI double staining, and expression of PKCδ mRNA and protein was detected by RT-PCR and Western blotting, respectively. Results Cell apoptosis significantly increased in fluid A+powder B group, with typical morphology of apoptosis. After treatment for 24 h and 48 h, cell apoptosis rates in fluid A+powder B group were significantly higher than those at corresponding time points in blank control group , normal control group and fluid A+powder B+rottlerin group (P<0.05). Compared with normal control group, blank control group and fluid A+powder B+rottlerin group, the expression of PKCδ mRNA and protein of U937 cells in fluid A+powder B group were significantly increased (P<0.05). There was no significant difference in cell apoptosis rates and expression of PKCδ mRNA and protein between fluid A+fluid B group and blank control group, normal control group and fluid A+fluid B+rottlerin group (P＞0.05). Conclusion Fluid A+powder B can significantly increase apoptosis of U937 cell line, the mechanism of which may be associated with the up-regulation of expression of PKCδ. Compared with fluid A+powder B, fluid A+fluid B is superior in reducing apoptosis of peripheral blood monouclear cells.

ObjectiveTo study the effect of Tanreqing injection （TRQ） on the pulmonary flora in the rat model of chronic obstructive pulmonary disease （COPD）. MethodWistar rats were randomized into control， model， and TRQ groups. The rats in other groups except the control group were treated by smoking combined with intratracheal instillation of lipopolysaccharide for the modeling of COPD. The TRQ group was intraperitoneally injected with TRQ （2 g·kg^-1）. At the end of the experiment， after blood collection from the abdominal aorta of the rats， the lung tissue was collected for hematoxylin-eosin and picric sirius red staining to reveal the pathological changes. The lung lavage fluid was collected， and the diversity and relative abundance of lung flora in different groups were analyzed by 16S rDNA amplicon sequencing. ResultThe lungs of the control group were normal， and those of the model group showed neutrophil infiltration， telangiectasia， lung hemorrhage and emphysema in individual cases， and thickening of collagen fibers in the trachea. Compared with the model group， the TRQ group showed significantly improved lungs and recovered collagen fibers. The MLI analysis showed that compared with the control group， the model group showcased increased alveolar space （P<0.01）， which was reduced in the TRQ group （P<0.05）. Compared with the control group， the model group showed increased wall thickness （P<0.01）， and the increase was attenuated in the TRQ group （P<0.01）. TRQ increased the Simpson index and altered the α diversity of pulmonary flora. The results of principal co-ordinate analysis showed that TRQ changed the β diversity and reduced the β diversity index of pulmonary flora. At the genus level， the model group showed increased relative abundance of g_Bacillus and g_Brevundimonas and decreased relative abundance of g_Pseudomonas， compared with the control group. After treatment with TRQ， the relative abundance of g_Stenotrophomonas increased， and that of g_Bacillus decreased. The LEfSe of differential taxa between groups showed that the modeling increased the relative abundance of g_Lachnospiraceae_NK4A136_group， and TRQ treatment increased the relative abundance of g_Rhodococcus and g_Stenotrophomonas. ConclusionTRQ can regulate the diversity of pulmonary flora and restore the balance of bacterial genera in the rat model of COPD， which may be one of the mechanisms of the prevention and treatment of COPD with TRQ.