Diabetes Complications ; drug therapy ; surgery ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Ischemia ; drug therapy ; etiology ; surgery ; therapy ; Lower Extremity ; blood supply

Objective To introduce the technique and experience in reconstruction of posterior crueiate ligament-posterolateral comer(PCL-PLC)injuries with only one allograft of Achilles tendon. Methods The instable knees in 12 cases with PCL injury combined with three degree chronic PLC injury were treated with PCL reconstruction under arthroscope and PLC reconstruction through posterolateral arc incision.Single bundle grafts of PCL reconstructions in tibial and femoral tunnels were fixed by resorption screws.Fibular collateral ligament(FCL)and popliteofibular ligament(PFL)were reconstructed with reforming Larson(?)method.All reconstruction grafts only needed one Achilles tendon as donator.Total op- eration time was 130 minutes including 90 minutes of PCL reconstruction and 40 minutes of PLC recon- struction.Gradual weight loading was allowed after six weeks of bracing.Results Follow-up for mean 12 months(5-24 months)indicated that tibial“step off”reduction was 83%(10/12)and posterior drawer test of 0-1~+ 75%(9/12).Dial sign evaluated that normal external rotation angle was 75%(8/12).Nor- real varus stress test at 30?knee flexion accounted for 83%(10/12).Scores of Lysholm,Tegner and HSS were 90.5,5.1 and 84.5,respectively(P＜0.01=.Conclusion Synchronized reconstruction of PCL and PLC injuries with only one Achilles tendon can obtain satisfactory clinical result,with less expense and shorter operation time.

OBJECTIVESTo investigate the different effects of closed suction drainage and non-drainage for total knee arthroplasty(TKA) and to provide reference information for the choice of clinical treatment.

METHODSRandomized controlled trials (RCTs) of closed suction drainage versus non-drainage for TKA were collected from the Cochrane Library, PubMed, EMBase, Springer, CBM, CNKI, VIP and WANFANG database. Methodological quality of the RCTs was independently assessed using the Consolidated Standards of Reporting Trials (CONSORT) checklist. Data analysis was performed by RevMan Version 5.1.6 based on the methods recommended by the Cochrane Collaboration.

RESULTSTwenty-one RCTs without bias were finally enrolled, and 1920 enrolled knees were identified into drainage group (979 knees) and non-drainage group (941 knees). A lower incidence of soft tissue ecchymosis was demonstrated in the closed suction drainage group (OR = 0.30, 95%CI: 0.24 - 0.49); however, compared with the non-drainage group, more loss of blood (MD = 320.03, 95%CI: 235.31 - 404.76) and more need of homologous blood transfusion (OR = 1.83, 95%CI: 1.26 - 3.29) were found in the closed suction drainage group. In addition, there were no significant differences of postoperative infection (OR = 0.53, 95%CI: 0.22 - 1.32), deep venous thrombosis (OR = 1.00, 95%CI: 0.46 - 2.18), and the joint range of motion (MD = -0.04, 95%CI: -1.11 - 1.02) between the two groups.

CONCLUSIONBased on the current evidence, no obvious advantage is demonstrated for closed suction drainage, in comparison with non-drainage for TKA.

Arthroplasty, Replacement, Knee ; Drainage ; statistics & numerical data ; Humans ; Postoperative Complications ; epidemiology ; Randomized Controlled Trials as Topic ; Range of Motion, Articular ; Venous Thrombosis ; epidemiology

OBJECTIVETo observe the effects of refined Xuefu Capsule (RXC) in patients with arteriosclerosis obliterans (ASO) after femoral-popliteal bypass (FPB).

METHODSThirty-eight ASO patients with 41 limbs underwent FPB were randomly assigned to two groups: the control group (18 cases with 20 operated limbs) and the RXC group (20 cases with 21 operated limbs). All patients received long-term anticoagulant treatment with Warfarin, and RXC was given to the RXC group additionally for 3 months. Changes of clinical symptoms, blood coagulating function, as well as the condition of vascular patency and ankle arm index (AAI) were assessed 6 and 12 months after operation.

RESULTSClinical symptoms were improved in all the patients after operation. One year after operation, incidence of intermittent claudication and amputation rate in the RXC group was 20% and 5 %, being lower than the respective rate (56% and 17%) in the control group (P < 0.05); the patency rate was 86% in the RXC group, being higher than that in the control group (65%, P<0.05). Six and 12 months after operation, AAI was 0.73 +/- 0.24 and 0.69 +/- 0.19 respectively in the RXC group, being significantly higher than that in the control group (0.45 +/- 0.17 and 0.41 +/- 0.23, P < 0.05) at the corresponding time points.

CONCLUSIONRXC could obviously increase the patency rate 12 months after FPB, improve the clinical symptoms and alleviate the symptom of limb ischemia in ASO patients.

Aged ; Aged, 80 and over ; Arteriosclerosis Obliterans ; drug therapy ; physiopathology ; surgery ; Blood Vessel Prosthesis Implantation ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Femoral Artery ; surgery ; Graft Occlusion, Vascular ; prevention & control ; Humans ; Male ; Middle Aged ; Phytotherapy ; Popliteal Artery ; surgery ; Vascular Patency ; drug effects

OBJECTIVETo explore the effects of Tongxinluo capsule (TXL) on the atherosclerosis obliterans (ASO) in iliofemoral artery of rabbits.

METHODRabbits were randomly divided into 7 groups: sham, model, TXL (0.8, 0.4, 0.2 g x kg(-1)), Tongsaimai tablet (0.8 g x kg(-1)) and Laishike (0.002 g x kg(-1)). The animal model of ASO was established with a combined method of mechanical trauma, immunologic injury and high fat fodder feeding. Rabbits were administrated the drugs 8 weeks after surgery. The levels of TC, TG, HDL-C and LDL-C in serum were determined at the time points below: pre-experiment (0 week), pre-drug administration (8 weeks post-surgery), 4 weeks after drug administration (12 weeks post-surgery), 8 weeks after drug administration (16 weeks post-surgery), 12 weeks after drug administration (20 weeks post-surgery). Meanwhile, the behavioral study was performed, the distal skin temperature of the injured hind limb detected. The histopathological changes in iliofemoral artery were examined after opacification.

RESULTThe levels of TC, TG, LDL-C, VLDL-C and TC/HDL-C were decreased significantly in serum of ASO rabbits. The severity of lameness in the injured hind limb was improved. The distal skin temperature was increased. The thickness and the ratio of intima area of the iliofemoral artery of the injured hind limb were decreased, while the stenosis extent was improved.

CONCLUSIONTXL might be beneficial to modulate blood lipid, as well as the prevention and treatment for ASO.

Animals ; Arteriosclerosis Obliterans ; blood ; pathology ; prevention & control ; Arthropods ; chemistry ; Behavior, Animal ; drug effects ; Capsules ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Femoral Artery ; drug effects ; pathology ; Iliac Artery ; drug effects ; pathology ; Male ; Materia Medica ; administration & dosage ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; Rabbits ; Random Allocation ; Triglycerides ; blood ; Tunica Intima ; drug effects ; pathology

OBJECTIVE: To evaluate the prospective association between cumulative resting heart rate (cumRHR) and rapid renal function decline (RRFD) in a cohort of individuals aged 60 and older. METHODS: In the Tianjin Chronic Kidney Disease Cohort Study, the individuals who underwent three consecutive physical examinations between 2014 and 2017, with estimated glomerular filtration rate (eGFR) greater than 60 mL/min per 1.73 m² and aged 60 years or older were enrolled. A total of 27,564 patients were prospectively followed up from January 1, 2017 to December 31, 2020. The 3-year cumRHR was calculated. The primary outcome was RRFD, defined as an annualized decline in eGFR of 5 mL/min per 1.73 m² or greater. Logistic and restricted spline regression models and subgroup analysis were used to investigate the association of cumRHR with RRFD after adjusting for all confounders. RESULTS: During a median follow-up of 3.2 years, a total of 4,347 (15.77%) subjects developed RRFD. In fully-adjusted models, compared with the lowest quartile of cumRHR, the odds ratio (OR) for the highest was 1.44 (1.28-1.61), P < 0.001. Furthermore, each 1-standard deviation (27.97 beats/min per year) increment in cumRHR was associated with a 17% (P < 0.001) increased risk of RRFD, with a linear positive correlation (P for non-linear = 0.803). Participants with a 3-year cumRHR ≥ 207 (beats/min) * year (equivalent to ≥ 69 beats/min per year in 3 years) were found to be at a higher risk of RRFD. CONCLUSIONS The cumRHR is significantly associated with a higher risk of RRFD among older adults. These results might provide an effective goal for managing and delaying the decline of renal function in the older adults.