Objective To study the functional mechanism of Naoxin tong Capsule (Ca psule for cerebral and heart diseases) on a cute coronary syndrome (ACS). Methods Totally 105 ACS p atients diagnosed with coro nary angiography were randomized into a treatment group (55 cases), and a control group (50 cases). The control group was treated routin ely with western medicine while the treatment group treated with Naoxintong Capsule, 2 capsules each time, 3 times a day, in addition to the routine western medicine. Before and 4 weeks after treatment, the serum hypersensitive C-react ive protein (hs-CRP) was measured. Before and six months af ter treatment, changes of carotid intima-media thickness (IMT) and carot id plaque were examined with Color Doppler Ultrasonography. Resu lts Four weeks after treatment, the hs-CRP level in the treatment grou p was significantly lowered than before treatmen t, and the effect was more significant than that of the control group (P

Objective:To compare our self-designed elastic syndesmosis hook plate (ESHP) and suture-button technique in treatment of injury to the distal tibiofibular syndesmosis.Methods:A retrospective study was conducted of the 53 patients who had been treated at Military Orthopaedic Center, 909 Hospital of Joint Service Support Force of PLA for ankle fractures complicated with syndesmosis injury by ESHP or suture-button technique from March 2013 to March 2017. Of them, 28 were treated by ESHP (ESHP group: 15 males and 13 females aged from 26 to 60 years) and 25 by suture-button technique (suture-button group: 14 males and 11 females aged from 24 to 59 years). The 2 groups were compared in terms of syndesmosis fixation time, postoperative incision bleeding, hospital stay, and ankle dorsiflexion and plantarflexion and ankle function by Baird-Jackson scoring at 3, 6, 12 months after surgery. Postoperative complications were observed.Results:The 2 groups were comparable because there was no statistically significant deference in general data between the 2 groups ( P>0.05). Surgery went on uneventfully in all the patients. The syndesmosis fixation time [(9.7±2.2) min] and postoperative incision bleeding [(49.3±10.4) mL] in the ESHP group were significantly less than in the suture-button group [(16.2±1.4) min and (62.4±6.3) mL] ( P<0.05); the maximum plantar flexion (29.9°±1.3°) and Baird-Jackson scores (87.2±2.9) at 3 months after surgery in the ESHP group were significantly greater than in the suture-button group (22.8°±1.3° and 78.7±4.1) ( P<0.05). There were no significant differences between the 2 groups in hospital stay, maximum plantar flexion at postoperative 6 or 12 months, maximum dorsiflexion at postoperative 3, 6 or 12 months, or Baird-Jackson scores at postoperative 6 or 12 months (all P>0.05). This cohort was followed up for 12 to 14 months (average, 12.5 months). All fractures united during follow-up and all the implants were removed around postoperative 12 months. Follow-up within 12 months observed internal fixation failure caused by metal fatigue in one case in the ESHP group, and internal fixation irritation in one case, internal fixation failure in 2 cases and internal fixation sinking and osteolysis in one case in the suture-button group. Conclusion:Compared with the suture-button technique, treatment of injury to the distal tibiofibular syndesmosis with ESHP may lead to shorter fixation time, less postoperative bleeding and complications, and faster functional recovery of the ankle.

Objective To explore the perioperative management and surgical outcomes of fracture-dislocation of the upper cervical spine complicated with vertebral artery injury.Methods We retrospectively analyzed the clinical data of 19 patients diagnosed with fracture-dislocation of the upper cervical spine complicated with vertebral artery injury who had been treated at our department from January 2008 through December 2012.They were 14 males and 5 females,aged from 22 to 53 years (mean,35.2 years).All the patients had fractures of the atlas and/or axis,and disordered atlanto-axial relationship as well.According to Frankel grading system,8 cases were Grade D and 11 Grade E.The cervical posterior fixation with pedicle screws was adopted for all and hemostasis was conducted for those with bleeding from the broken vertebral artery.Their Frankel grade,Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) score were compared between preoperation and final follow-up.Results Intraoperative hemorrhage occurred in 2 patients from the injured vertebral artery.Hemostasis was achieved through direct tamponade with bone wax and gelatin sponge in one and through endovascular intervention after bleeding control by direct tamponade in another.Neither of them presented with symptoms of posterior circulation ischemia after operation.The mean operation time was 153.5 min,and the mean blood loss was 542.1 mL.All the patients were followed up for an average time of 28 months.Bony union was obtained in all after an average time of 13.5 weeks.Follow-ups revealed no ischemic stroke in this series.Symptoms of transient ischemic attack,like transient dizziness and blurred vision,appeared in 2 patients.At the final follow-up,all the patients were assessed as Frankel Grade E.Their mean JOA and VAS scores were significantly improved from 8.1 ± 1.2 and 7.0 ± 1.7 preoperatively to 12.7 ± 1.6 and 1.3 ± 1.2,respectively (P ＜ 0.05).Conclusions Angiography examination is routinely indicated for the patients with fracture-dislocation of the upper cervical spine perioperatively.Preoperative evaluation of the vertebral artery and its adjacent structures and effective intraoperative hemostasis can avoid uncontrollable bleeding during operation,reduce postoperative complications,and improve surgical outcomes.

Objective To develop and apply portable bracket of lower limb in operation of tibia interlocking intramedullary nail. Methods Portable bracket of lower limb is composed of two fir panels and support structure. The level of support and the knee flexion is controlled with it. It is used in preoperative high-pressure disinfection, and then trouble limb is placed on the bracket to complete operation of tibia interlocking intramedullary nail. Results The applications save labor, reduce iatrogenic injury, make for union of fracture and avoid radiation damage of staff. No one is used to lift up leg in operation procedure and X-ray examination. Conclusion Potable bracket of lower limb has advantages in simple production, low cost, labor-saving, minimally invasive surgery wound and so on.

OBJECTIVETo design a kind of internal fixation device to treat the syndesmosis injury.

METHODSThe elastic syndesmosis hook plate is made of medical stainless steel alloy, which is consisted of locking or common screw fixing hole of the tibial side for the head, tridentate fork like arc anatomical fibula side plate for the tail and serpentine elastic connecting body. By reduction of the joint of the lower tibia and fibula, the steel plate tail is fixed at the side of the fibula and the head is fixed at the side of the tibia for fixing the symphysis.

RESULTSThe design of elastic syndesmosis hook plate is reasonable, and the operation is convenient. There is no need to penetrate the substantia ossea and the plate has elastic micro-movement feature, the problem of internal fixation breakage and loosening is avoid in huge degree, so it is safe and reliable.

CONCLUSIONThe elastic syndesmosis hook plate is a new type medical apparatus of internal fixation of the symphysis, which is worthy of clinical popularization and application.

AIM:To observe the expression of nuclear factor-kappa B ( NF-κB) , N-methyl-D-aspartic acid re-ceptor 2B (NR2B) and inducible nitric oxide synthase (iNOS) in the spinal cord in a rat model of chronic constriction in-jury (CCI) of the sciatic nerve.METHODS:Fifty-six adult male Sprague-Dawley rats weighing 180~220 g were random-ly divided into sham group (n=8) and CCI group (n=48).The mechanical withdrawal threshold (MWT) and paw with-drawal latency (PWL) of the hind paws were measured 1 d before CCI and 1 d, 4 d, 7 d, 14 d and 21 d after surgery.The L4~L6 segment of the spinal cord was taken for determining the expression of NF-κB, NR2B and iNOS by RT-PCR and Western blotting.RESULTS:At 1 d, 4 d, 7 d, 14 d and 21 d after surgery, the MWT and PWL in CCI group were obviously lower than those in sham group .The expression of NF-κB, NR2B and iNOS at mRNA and protein levels in-creased significantly.Positive correlations were found between the mRNA expression of NF-κB and iNOS (r=0.842, P<0.05), and between the mRNA expression of NR2B and iNOS (r=0.833, P<0.05).CONCLUSION:The generation and maintenance of hyperalgesia in sciatic nerve injury rats may attribute to the activation of NF -κB and NR2B and concom-itant increase in iNOS .

Objective To evaluate the possibility and curative effect of total en bloc spondylectomy (TES) for the treatment of primary tumors of the lumbar spine. MethodsBetween June 2005 and July 2009,nine cases of primary tumor of the lumbar spine were treated with total en bloc spondylectomy through a single posterior approach performed in seven cases(L1 giant cell tumor, L1 osteosarcoma, L2 giant cell tumor,L2 solitary plasmacytoma, L2 chondrosarcoma, L2 chordoma, and L3 histiocytic sarcoma), and two cases through a single stage anterior and posterior combined approach (L4 giant cell tumor with paraspinal mass and L4 fibrosarcoma). They were performed a single stage reconstruction after removing tumors of vertebra. Neurofunction was evaluated perioperatively and recurrence of tumor was tracked for all cases.ResultsThe follow up was obtained for 3-49 months (averaging 19 months). All patients attained significant clinical improvement after surgery without any severe complications. There was no local recurrence and distal metastasis in shortterm follow-up. ConclusionThe treatment by TES to remove tumors and reconstruction of spine are reliable for primary tumors of the lumbar spine. The curative effect of short-term follow-up is satisfactory. However, the long-term curative effect remain to be further follow-up.

A new production method of spraying dextran-based polyurethane external splints is introduced in this paper. The main raw material components are polymethylene polyisocyanate (PAPI), mixed with surfactants, acetone, soluble starch, catalyst, and so on. The splint is used for temporary fixing after fracture, with small size, light weight, easy portability, fine air perviousness, completely transparent to the X-ray. It also needs a shorter fixed operating time. It can not only fix quickly and effectively the vertebral column and limbs, but also significantly shorten the time of pre-hospital care.
Dextrans ; Equipment Design ; External Fixators ; First Aid ; instrumentation ; Fracture Fixation ; instrumentation ; Fractures, Bone ; surgery ; Polyurethanes ; Splints

To develop standard in vitro chondrosarcoma models, we synthesized three hydrogels (i. e., PDMAAm, PNaAMPS and PMETAC) and investigated the influence of Young's modulus, swelling ratio and electric charges on the behavior of chondrosarcoma cells seeded on the hydrogels, including morphology, adhesion and aggregation. Results showed that the morphology of chondrosarcoma cells at 6h was dependent on the charges of hydrogels; cells present spindle-shaped and round-shaped morphology on negative charged and neutral hydrogel, respectively, while no cells spreaded on positive charged hydrogel. Chondrosarcoma cells formed aggregates on neutral PDMAAm after further culture. The hydrogels can be synthesized easily and has the characteristics of ease at use with defined components, which holds great potential for developing standard chondrosarcoma models in vitro.
Bone Neoplasms ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Chondrosarcoma ; pathology ; Humans ; Hydrogels ; chemistry ; pharmacology ; Methacrylates ; pharmacology ; Nylons ; pharmacology ; Static Electricity

Objective:To investigate the clinical efficacy of distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries.Methods:A retrospective cohort analysis was made on clinical data of 72 patients with ankle fracture accompanied with distal tibiofibular syndesmosis injuries admitted to 909th Hospital of Joint Service Support Force of PLA from September 2017 to September 2020, including 38 males and 34 females, aged 19-65 years [(42.5±12.2)years]. The fracture was type B in 30 patients, type C 1 in 29 and type C2 in 13 according to Danis-Weber classification. A total of 36 patients were treated by distal tibiofibular screw fixation combined with ligament repair (fixation+repair group) and 24 patients by distal tibiofibular screw fixation (fixation group). Operation time, intraoperative blood loss and hospital stay were recorded. Visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score and ankle range of motion (ROM) were determined at 1, 3 months postoperatively and at the final follow-up. Complications were documented. Results:All patients were followed up for 12-22 months [(15.9±2.2)months]. There were no significant differences in operation time, intraoperative blood loss and hospital stay between the two groups (all P>0.05). VAS in fixation+repair group was (3.1±1.0)points and (2.1±0.6)points at 1, 3 months postoperatively, significantly lower than (3.9±0.8)points and (2.6±0.8)points in fixation group (all P<0.05), but the score showed no significant difference between the two groups at the final follow-up ( P>0.05). AOFAS score in fixation+repair group was (64.7±4.0)points, (73.2±3.4)points and (87.2±3.4)points at 1, 3 months postoperatively and at the final follow-up, significantly higher than (60.1±4.9)points, (70.2±1.9)points and (84.1±2.6)points in fixation group (all P<0.05). There was no significant difference in the ROM between the two groups at 1 month postoperatively ( P>0.05), but the ROM at 3 months postoperatively and at the final follow-up in fixation+repair group [(44.4±2.9)° and (52.3±2.5)°, respectively] was significantly higher than that in fixation group [(41.4±2.7)° and (50.1±2.7)°, respectively] (all P<0.05). There was 1 patient with internal fixation loosening in fixation+repair group, with the incidence of complications of 3% (1/36). While the incidence of complications was significantly lhigher in fixation group [17%(6/36)], including 2 patients with re-separation of distal tibiofibular syndesmosis, 2 with internal fixation loosening and 2 with internal fixation breakage ( P<0.05). Conclusion:Compared with distal tibiofibular screw fixation, distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries is effective to early relieve ankle pain, improve ankle function and ROM, and reduce occurrence of complications.