Objective To investigate the effects ofTongbicapsule on the knee joint function and the synovial fluid levels of matrix metalloproteinase (MMP)-3,-9 in patients with knee osteoarthritis.Methods A total of 76 patients with knee osteoarthritis were randomly divided into a control group and an observation group according to the random number table, 38 in each group. Patients in the control group were treated with glucosamine hydrochloride capsules, while patients in the observation group were givenTongbicapsule on the basis of the control group. Both groups were treated for 12 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index was used to measure the knee joint function, and enzyme-linked immunosorbent assay was used to determine the synovial fluid levels of MMP-3 and MMP-9.Results The knee joint function in the observation group was significantly improved than that in the control group (94.74%vs. 78.95%;χ2=4.146, P<0.05). The synovial fluid levels of MMP-3 (67.58 ± 22.35 ng/mlvs.93.51 ± 27.84 ng/ml;t=4.477,P<0.01) and MMP-9 (36.24 ± 10.56 ng/mlvs.51.87 ± 12.35 ng/ml;t=5.930,P<0.01) in the observation group patients were significant lower than those in the control group after treatment.ConclusionsTongbicapsule was effective in treating knee joint function in patients with knee osteoarthritis, and its mechanism may be related to its reducing the synovial fluid levels of MMP-3 and MMP-9.

Diabetic foot ulcer is a major complication of diabetes which is the most expensive and the most difficult to deal with and leads to a high rate of non-traumatic amputation.Diabetic foot osteomyelitis results from aggravation of diabetic foot ulcer.Unfortunately,the current therapeutic outcomes of diabetic foot osteomyelitis are still unsatisfactory because of its difficult diagnosis and special treatment protocols which are entirely different from those for conventional soft tissue infections.This paper summarizes the latest advances achieved in diagnosis and treatment of diabetic foot osteomyelitis.

Objective:To compare the clinical effects on new bone formation and foot-ankle function between proximal tibial bone transport and distal tibial bone transport in the treatment of massive bone defects after tibial osteomyelitis debridement.Methods:From July 2012 to July 2017, 42 patients with chronic tibial osteomyelitis received bone transport surgery at Department of Orthopaedics, Nanfang Hospital.According to the Cierny-Mader classification for chronic osteomyelitis, all of them belonged to diffusive tibial osteomyelitis (type IV).Of them, 32 were treated by proximal tibial bone transport after tibial osteomyelitis debridement.In the proximal group, there were 27 males and 5 females, aged from 17 to 65 years and involving 20 left and 12 right sides. The other 10 cases received distal tibial bone transport. In the distal group, all of them were male, aged from 25 to 63 years and involving 6 left and 4 right sides. The 2 groups were compared in terms of external fixation index (EFI) and American Orthopaedic Foot & Ankle Society(AOFAS) Ankle and Hindfoot Scale.Results:There were no significant differences between the 2 groups in the preoperative general data such as gender, age or osteomyelitis site, indicating the 2 groups were comparable ( P>0.05). Both groups obtained complete follow-up. The proximal group was followed up for 590.1 d ± 287.3 d and the distal group for 615.6 d ± 130.6 d, showing no significant difference between groups ( P>0.05). In the proximal group 2 cases developed talipes equinovalgus after bone transport while in the distal group 3 cases did, and surgical intervention was needed for them. Surgical intervention was also carried out for16 cases of non-union at the docking site in the proximal group and for 2 ones in the distal group. The EFI was 76.2 d/cm±50.0 d/cm for the proximal group and 84.3 d/cm ± 59.9 d/cm for the distal group, showing no significant difference between groups ( P>0.05). The AOFAS scores were 81.4±10.1 for the proximal group and 60.0±5.9 for the distal group, showing a significant difference ( P<0.05). Conclusion:In the treatment of massive bone defects after tibial osteomyelitis debridement, no significant difference has been observed in the effect on bone formation between proximal tibial bone transport and distal tibial bone transport, but the former transport may have a less adverse effect on foot-ankle function.