Objective To observe the dynamic changes of brain edema,tumor necrosis factor-α (TNF-α),aquaporin-4 (AQP-4) in focal cerebral ischemia rats and investigate the effect of atorvastatin on the above-mentioned factors.Methods One hundred and eight male SD rats were randomly divided into sham-operated group,model group and treatment group (n=36);furthermore,each group was divided into three subgroups:1 d group,3 d group and 7 d group (n=12).Focal cerebral ischemia models in model group and treatment group were induced by left middle cerebral artery occlusion,while rats in the sham-operated group were only separated from blood vessels with no ligation and no inserted line.After succeeded models,the treatment group received gavage administration of atorvastatin (4 mg/ [kg·d]),others were given the same dosage of normal saline at the same time.The brain edema was calculated by measuring brain water content via dry-wet method,and the mRNA expressions of TNF-α and AQP-4 were detected by real time-PCR;Western blotting was employed to detect the AQP-4 protein expression.Results At the same observation time,as compared with those in the sham-operated group,the brain water content,TNF-α mRNA expression and A QP-4 mRNA and protein expressions in the model group and treatment group markedly increased (P＜0.05);as compared with the model group,treatment group had statistically decreased brain water content,TNF-α mRNA expression and AQP-4 mRNA and protein expressions (P＜0.05).Conclusion The brain edema of focal cerebral ischemia rats may be positively correlated to AQP-4 mRNA and protein expressions induced by TNF-α;atorvastatin probably down-regulates AQP-4 mRNA and protein cxpressions by inhibiting TNF-α to alleviate brain edema and protect brain tissues.

Objective:To explore the experience of the treatment of patella inferior pole fracture with non excitation tension band technique.Methods:From April 2009 to December 2019, 76 patients with inferior patellar fracture were treated with non excitation tension band technique. There were 42 males and 34 females; The age was 35.48 ± 18.12 years (17-66 years), with an average of 35 years. There were 45 cases on the left and 31 cases on the right. Causes of injury: fall injury in 46 cases, bicycle injury in 16 cases and traffic accident injury in 14 cases. The time from injury to operation was 0.25-5 d, with an average of 3.2 d. There were 18 cases of open fractures, 64 cases of articular surface fractures and 52 cases of comminuted fractures. Open fracture patients were debridement first, and all cases were fixed with non excitation tension band technique. The intraoperative fracture reduction, postoperative fracture healing and internal fixation were observed. The knee function was evaluated according to the degree of claudication, the use of supports, the feeling of joint strangulation, joint instability, pain, swelling, stair climbing and squatting.Results:All 76 patients successfully completed the operation and were followed up for 18.24 ± 6.18 months (range 12-24 months). There was no wire fracture during and after operation. All incisions healed in the first stage after operation, and there was no deep venous thrombosis of lower limbs. The X-ray film showed that there was no further fracture and fracture displacement after operation, and there was no Kirschner wire slip before the internal fixation was taken out. Only one case had steel wire relaxation due to buckle (which did not affect fracture healing). All fractures healed well, with an average of 7.5 weeks, and the fracture line basically disappeared. 12 months after operation, according to Lysholm knee score standard, the knee function of patients was evaluated. The score of 76 cases was 95.40±4.60 points (range 82-100 points): excellent in 54 cases, good in 21 cases and fair in 1 case. The excellent and good rate was 98.7%. According to the visual analogue scale (VAS) pain score standard, the patients were scored for postoperative pain. The score of 76 cases was 0.09±2.05 points (range 0-3 points): 4 cases had mild pain, with an average score of 0.09.Conclusion:The results of the treatment of patellar inferior pole fracture with tension free band technique are satisfactory, the pain caused by tissue irritation by the internal fixation was lower, clinical application can be popularized.