BACKGROUND:There are many reports about clinical effect of femoral fractures with intramedul ary nail and distal femoral fractures with locking plate. However, there is less report about clinical effect of femoral and distal femoral fractures.
OBJECTIVE:To investigate the clinical effect of femoral and distal femoral fractures using intramedul ary nail combined with locking plate.
METHODEighteen patients with femoral and distal femoral fractures were treated by internal fixation with intramedul ary nail combined with locking plate. Among them, six cases had femoral and supracondylar fractures, seven cases had femoral and condylar fractures, and five cases had femoral and intercondylar fractures.
According to the AO classification, three cases were type 33A2, three cases were type 33A3, two cases were type 33B1, five cases were type 33B2, one case was type 33C1, three cases were type 33C2, and one case was type 33C3. The fractures union and complications were fol owed up and observed, and knee joint function was judged by HSS score.
RESULTS AND CONCLUSION:Al the 18 patients were fol owed up for 12-24 months. The time for fracture union ranged from 3 to 5 months, average 3.4 months. No infection and disunion, no fracture malunion, no internal fixation loosening and breaking, no refracture happened. The HSS score ranged from 68 to 96 points, average 86.8 points. There were 12 excellent cases, 5 good cases, and 1 common case. The excellent and good rate was 94.4%. The internal fixation using intramedul ary nail combined with locking plate is a good method for treatment of femoral and distal femoral fractures, due to less surgical trauma, simple and reliable fixation, high rate of fracture healing, low rate of complications, and excellent function.

Objective To compare the short-term effects of proximal humerus fractures by deltoid approach or delto-pectoral approach .Methods The clinical records of 53 patients with proximal humeral fracture for two kinds of different treatment were re-viewed :delto-pectoral approach with anatomical form plate(delto-pectoral group ,24 cases) or anterolateral deltoid approach with locking proximal humerus plate (anterolateral deltoid approach group ,29 cases) from May 2008 to May 2013 .The length of inci-sion ,bleeding volume ,postoperative painscores ,union of fracture time ,incidence of complications ,pain and function of shoulder score (Neer scores) were compared and recorded .Results All the patients were followed up for 6 - 24 months(mean 16 .3 month) , and all patients obtained bone union .The anterolateral deltoid approach was significantly higher than delto-pectoral approach in the operation fime ,the bleeding volume ,postoperative painscores ,union of fracture time ,pain and function of shoulder score(after a month)(P< 0 .05) .There were not significant differences of function of shoulder score (beyond 6 months)(P > 0 .05) .By delto-pectoral approach ,there were 2 cases with delayed wound healing ,3 cases underwent the loosening of screw ,4 cases humerus head varus and 2 cases necrosis of head of humerus ,with the rate of complications of 45 .8% .On the other hand ,deltoid approach group were 2 cases underwent screw cutting and 2 cases humerus head varus ,with the rate of complications of 13 .8% (P< 0 .05) .Conclu-sion The clinical results of anterolateraldeltoid approach group with locking proximal humerus plate had the advantage of reliable fixation ,less suffering ,less surgical trauma and less complication ,which was better the short-term effects than delto-pectoral ap-proach with atomical from plate .

Objective To explore the effect of traumatic brain injury on the fracture healing and its related mechanism by observing the expression of platelet-derived growth factors (PDGF) in serum and bone callus in rats with bone fracture and cerebral trauma.Methods One hundred and forty-four SD rats were randomized into 4 equal groups (n =36) which were subjected respectively to:no treatment (group N),traumatic brain injury (group TBI),bone fracture (group F) and bone fracture and cerebral trauma (group TBI + F).The animals were sacrificed at 3 days,1,2,3 and 4 weeks after modeling.In all the 4 groups,ELISA was used to detect the expression of PDGF in serum.In groups F and TBI + F,the callus growth was observed at the right tibial fracture site by X-ray,the callus growth and morphology were also observed by HE staining,the expression of PDGF in the callus tissue was measured by immunohistochemieal analysis,and the expression of PDGF mRNA in the callus tissue was measured by RT-PCR.Results X-ray showed that fracture healing was accelerated in group TBI + F compared with group F.The serum expression of PDGF in group TBI + F was significantly higher and the peak time was significantly earlier than in the other 3 groups (P ＜ 0.05).H-E staining showed that osteoblastic activity at the fracture ends in group TBI + F was stronger than in group F.Inmunohistochemica[staining showed that the expression of PDGF in the local callus was significantly higher at 3 days and 1 week in group TBI + F and the peak time was significantly earlier than in group F (P ＜ 0.05).RT-PCR showed that the expression of PDGF mRNA in the local callus was significantly higher at 3 days and 1 week in group TBI + F than in group F (P ＜0.05).Conclusions Traumatic brain injury can promote fracture healing in rats,which is probably related to increased expression of PDGF after cerebral trauma.

Objective:To investigate the effects of miR-219a-5p on proliferation, invasion and migration of osteosarcoma U2OS cells by regulating high mobility group A2 (HMGA2) .Methods:Real-time quantitative PCR was used to detect miR-219a-5p mRNA expression levels in osteosarcoma U2OS cells and normal osteoblasts hFOB1.19. The U2OS cells were transfected with miR-219a-5p mimic (miR-219a-5p mimic group) and negative control mimic (mimic NC group) by liposome transfection. The expression levels of miR-219a-5p and HMGA2 mRNA in transfected cells were detected by real-time quantitative PCR. The level of HMGA2 protein was detected by Western blotting, cell proliferation ability was detected by CCK-8 assay and clonogenesis assay, cell migration ability was detected by scratching assay, cell invasion ability was detected by Transwell chamber assay, and the relationship between miR-219a-5p and HMGA2 was verified by double luciferase reporter gene assay.Results:Real-time quantitative PCR showed that the expression level of miR-219a-5p in osteosarcoma U2OS cells (0.11±0.01) was significantly lower than that in normal osteoblasts (1.00±0.06) , with a statistically significant difference ( t=26.83, P<0.001) . The results of CCK-8 showed that the cell absorbance values of the mimic NC group and miR-219a-5p mimic group were 0.52±0.02 and 0.42±0.02 after 24 h, 0.85±0.03 and 0.60±0.03 after 48 h, and 1.12±0.02 and 0.72±0.02 after 72 h respectively. The proliferation activity of the miR-219a-5p mimic group was significantly lower than that of the mimic NC group, with statistically significant differences ( t=6.97, P<0.001; t=16.65, P<0.001; t=26.78, P<0.001) . The results of clonogenesis assay showed that the number of clones in the miR-219a-5p mimic group was 157.00±15.39, which was significantly lower than that in the mimic NC group (294.00±15.51) , with a statistically significant difference ( t=9.70, P<0.001) . The results of scratch experiment showed that the percentage of scratch area in the miR-219a-5p mimic group was (40.53±2.92) % after 24 h culture, which was significantly higher than that in the mimic NC group [ (21.71±3.11) %], with a statistically significant difference ( t=7.26, P=0.002) . The results of Transwell chamber assay showed that the number of cells penetrating the membrane in the miR-219a-5p mimic group was 128.67±18.67, which was significantly lower than that in the mimic NC group (317.67±14.33) , with a statistically significant difference ( t=15.65, P<0.001) . The results of double luciferase reporter gene assay showed that in MUT-HMGA2 cells, transfection with miR-219a-5p mimic (4.30±0.26) had no significant effect on luciferase activity compared with the mimic NC group (4.40±0.28) , with a statistically significant difference ( t=0.85, P=0.690) . In WT-HMGA2 cells, compared with the mimic NC group (4.50±0.25) , the lucifase activity of the miR-219a-5p mimic group (2.88±0.16) was significantly decreased, with a statistically significant difference ( t=19.15, P<0.001) . After miR-219a-5p was overexpressed, HMGA2 mRNA and protein expressions in osteosarcoma U2OS cells (0.77±0.01; 0.37±0.01) were downregulated compared with the mimic NC group (1.00±0.02; 1.00±0.01) , with statistically significant differences ( t=16.38, P<0.001; t=42.02, P<0.001) . Conclusion:In osteosarcoma cells, miR-219a-5p can inhibit the proliferation, migration and invasion of osteosarcoma cells by down regulating the expression of HMGA2.

BACKGROUND:Unicompartmental knee arthroplasty has been paid more and more attention because of its advantages of fewer traumas,less blood loss,less complications,faster recovery,excellent knee function and high prosthetic survival rate.Most of the relevant reports focused on its clinical effect,but the changes in the levels of relevant inflammatory cytokines in patients after unicompartmental knee arthroplasty were rarely reported. OBJECTIVE:To investigate the effect of unicompartmental knee arthroplasty in patients with medial compartment osteoarthritis of the knee and the changes of interleukin-1,interleukin-6,and tumor necrosis factor-α levels. METHODS:A total of 30 patients with medial compartment osteoarthritis of the knee who received unicompartmental knee arthroplasty from September 2021 to March 2023 and met the inclusion criteria were selected as the study subjects.Medial angle of proximal tibia,femoral and tibial angle,pain visual analog scale score,hospital for special surgery score,knee joint range of motion,synovial fluid interleukin-1,interleukin-6,and tumor necrosis factor-α levels before and after surgery were compared and statistically analyzed. RESULTS AND CONCLUSION:(1)All 30 patients had grade I wound healing.All patients were followed up for more than 6 months after surgery.There were no complications such as prosthesis loosening and dislocation of prosthesis liner in all patients.(2)The medial proximal tibia angle and the femoral and tibial angles measured after operation were significantly improved(P<0.05).(3)The visual analog scale score,hospital for special surgery score and range of motion measured at 1,3,and 6 months after operation were better than those before operation(P<0.05),and showed a gradual improvement(P<0.05).(4)The levels of interleukin-1,interleukin-6,and tumor necrosis factor-α in synovial fluid at 3 and 6 months after operation were decreased gradually compared with those before operation(P<0.05)and showed a gradual downward trend at each time point after operation.(5)It is indicated that unicompartmental knee arthroplasty can effectively treat medial compartment osteoarthritis of the knee,significantly relieve pain,restore knee joint function,improve knee varus deformity and lower limb strength line,and reduce the levels of inflammatory cytokines interleukin-1,interleukin-6,and tumor necrosis factor-α in joints to a certain extent.