Objective:To explore the safety, efficacy and preliminary clinical application of the single plantar approach or in combination with the dorsalis pedis approach in the treatment of Lisfranc injury with poor dorsalis pedis soft tissue, metatarsal avulsion fracture or complicated multi-column lesions.Methods:(1) Six fresh cadaveric specimens of adult foot were collected and dissected through the plantar approach in order to determine the skin incision of the plantar approach and the safe area for plate-screw internal fixation, including start-stop points and courses of plantar nerves, blood vessels, tendons and ligaments, followed by plate-screw fixation on the specimens. (2) After feasibility of the plantar approach was confirmed by our anatomical study, it was used to treat the 3 patients who were admitted to Department of Orthopedics, The Third Hospital Affiliated to Southern Medical University between September 2020 and November 2021 for Lisfranc injury with severe necrosis due to dorsalis pedis skin contusion or metatarsal base avulsion fracture. They were 2 males and one female, with an average age of 51 years (from 34 to 68 years). The preliminary clinical efficacy was evaluated in terms of visual analogue scale (VAS), midfoot score of American Orthopaedic Foot and Ankle Surgeons (AOFAS), Maryland score, Kofoed score, fracture healing at the last follow-up and postoperative complications.Results:(1) Regarding the anatomical exposure range, the metatarsal side of the first metatarsal wedge joint was exposed medially and the metatarsal side of the third metatarsal wedge joint was exposed laterally; the peroneus longus tendon, Lisfranc plantar ligament and interosseous ligament were explored. X-ray films after the simulated operation showed satisfactory plate positions. (2) As for the preliminary clinical application, all patients were followed up for 6 to 14 months (mean, 11 months). At the last follow-up, the VAS score ranged from 0 to 1 (mean, 0.5), AOFAS score from 85 to 92 (mean, 89), Maryland score from 93 to 96 (mean, 95), and Kofoed score from 92 to 95 (mean, 94). There were no early complications such as fascial compartment syndrome, skin necrosis or infection. All fractures got united, with no complications like traumatic arthritis, muscle atrophy or screw loosening.Conclusion:Testified by the anatomical study, the plantar approach can be used to treat Lisfranc injury with poor dorsalis pedis soft tissue, metatarsal avulsion fracture or complicated multi-column lesions, leading to safe, effective and satisfactory clinical outcomes.

Objective:To investigate the changes, distribution and influencing factors of ocular dominance after small incision lenticule extraction (SMILE).Methods:A retrospective observational case series study was conducted.One hundred and twelve patients (224 eyes) with an average age of 25.1±5.4 years who underwent SMILE surgery at Tianjin Eye Hospital from November 2017 to February 2018 were enrolled.There were 42 male and 70 female patients.The dominant eye was determined using the hole-in-the-card test before and after the surgery.Subjective and objective refraction and uncorrected visual acuity examination were performed before operation, and 1 day, 1 week, 1 month and 3 months after operation.The subjects were divided into switch group and non-switch group based on whether the dominant eye changed after surgery.Binary logistic regression was used to analyze the main influencing factors of dominant eye switches.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.201905). Written informed consent was obtained from each patient before any medical examination.Results:There were 18 patients (16.1%) in the switch group including 7 males (38.9%) and 11 females (61.1%), and 94 patients (83.9%) in the non-switch group including 35 males (37.2%) and 59 females (62.8%). No statistically significant difference was found in sex between the two groups ( χ2=0.02, P=0.89). At 1 month and 3 months after the surgery, there was a statistically significant difference in the cylindrical power between the dominant and non-dominant eye ( t=2.31, 1.95; both at P<0.05). Binary logistic regression equation showed that spherical equivalent[odds ratio ( OR)=0.47, 95%confidence interval ( CI): 0.35-0.66]and refractive error difference ( OR=3.04, 95% CI: 2.12-4.36) were significantly related to the eye dominance switches. Conclusions:There were 16.1% of patients having eye dominance switches after SMILE.The dominant eye transfomation is associated with higher spherical equivalent and anisometropia difference before surgery.

Objective:To investigate the differences in refractive astigmatism, the anterior corneal surface astigmatism and ocular residual astigmatism between dominant and non-dominant eyes in myopia.Methods:A corss-sectional study was conducted.Two hundred and seventy-six eyes from 138 patients with myopia who were to receive corneal refractive surgery in the Refractive Surgery Center of Tianjin Eye Hospital from January to March 2018 were included.Ocular dominance was assessed with the hole-in-the-card test.The manifest refraction and corneal topography were performed in order to measure the sphericity, spherical equivalent, the astigmatism of anterior corneal surface and total cornea.Vector analysis was used to calculate the value of the ocular residual astigmatism and the components of astigmatism, including J0 and J45 of both the refractive astigmatism and the astigmatism of anterior corneal surface.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.201909).Results:It was found that 61.6%(85/138) of the subjects was right-eye dominant.There was no significant difference in sphericity and spherical equivalent, J0 and J45 of the refractive astigmatism and the astigmatism of anterior corneal surface between dominant and non-dominant eyes (all at P>0.05). The magnitude of the ocular residual astigmatism of the dominant eye was 0.607(0.451, 0.808)D, which was lower than 0.701(0.497, 0.901)D of the non-dominant eye, showing a statistically significant difference ( Z=-2.52, P=0.01). Conclusions:In the myopic population with no significant difference in the sphericity and spherical equivalent between the dominant and non-dominant eyes, the magnitude of the ocular residual astigmatism of the dominant eye is significantly lower than that of the non-dominant eye, which may play an important role in the ocular dominance formation.

Objective To evaluate biomechanical properties of the nickel-titanium (NiTi) memory alloy stent and its in vitro biomechanical properties for lumbar interbody fusion. Methods The mechanical properties of the NiTi memory alloy stent were tested on mechanical testing machine. Moreover, lumbar interbody fusion was simulated on fresh lumbar specimens, and biomechanical properties of the NiTi memory alloy stent with matching bone graft for used for lumbar interbody fusion were analyzed and compared with the traditional box-shape cage. Results The maximum compressive strength of the NiTi memory alloy stent was ( 12 964 ± 962) N. The maximum deformation within the effective range of memory characteristics was (4. 68±0. 03) mm. The recovery rate of the NiTi memory alloy stent was up to 99. 86% . Compared with the intact lumbar model, the stability of the operative segment after the simulated lumbar interbody fusion using NiTi memory alloy stent alone was increased in the direction of anterior flexion, posterior extension, lateral flexion and rotation, which was equivalent to the box shape cage group (P>0. 05). After the combined use of autogenous bone granule and absorbable bone cement the ROM of the operative segment was further reduced (P<0. 05), which was equivalent to the box-shape cage+ unilateral posterior fixation group (P>0. 05). The pull-out strength of the NiTi memory alloy stent with matching bone graft group was significantly stronger than that of the box-shape cage group (P<0. 05). Conclusions The NiTi memory alloy stent in this study was designed with a matched bone granule-absorbable bone cement graft,which provided a new idea for the further optimization and development of lumbar interbody fusion. With excellent support and deformation properties, this NiTi memory alloy stent is biomechanical equivalent to the traditional box shape cage for lumbar interbody fusion, and can greatly improve the stability of surgical segment and the pull-out strength of implants after the combined use of autogenous bone granule and absorbable bone cement.

Plant metabolites are important for plant development and human health. Plants of celery (Apiumgraveolens L.) with different-colored petioles have been formed in the course of long-term evolution. However, the composition, content distribution, and mechanisms of accumulation of metabolites in different-colored petioles remain elusive. Using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS), 1159 metabolites, including 100 lipids, 72 organic acids and derivatives, 83 phenylpropanoids and polyketides, and several alkaloids and terpenoids, were quantified in four celery cultivars, each with a different petiole color. There were significant differences in the types and contents of metabolites in celery with different-colored petioles, with the most striking difference between green celery and purple celery, followed by white celery and green celery. Annotated analysis of metabolic pathways showed that the metabolites of the different-colored petioles were significantly enriched in biosynthetic pathways such as anthocyanin, flavonoid, and chlorophyll pathways, suggesting that these metabolic pathways may play a key role in determining petiole color in celery. The content of chlorophyll in green celery was significantly higher than that in other celery cultivars, yellow celery was rich in carotenoids, and the content of anthocyanin in purple celery was significantly higher than that in the other celery cultivars. The color of the celery petioles was significantly correlated with the content of related metabolites. Among the four celery cultivars, the metabolites of the anthocyanin biosynthesis pathway were enriched in purple celery. The results of quantitative real-time polymerase chain reaction (qRT-PCR) suggested that the differential expression of the chalcone synthase (CHS) gene in the anthocyanin biosynthesis pathway might affect the biosynthesis of anthocyanin in celery. In addition, HPLC analysis revealed that cyanidin is the main pigment in purple celery. This study explored the differences in the types and contents of metabolites in celery cultivars with different-colored petioles and identified key substances for color formation. The results provide a theoretical basis and technical support for genetic improvement of celery petiole color.
Anthocyanins ; Apium/metabolism* ; Chlorophyll/metabolism* ; Color ; Gene Expression Regulation, Plant ; Humans ; Metabolomics ; Plant Proteins/genetics* ; Tandem Mass Spectrometry