OBJECTIVE: To investigate the effectiveness of tibial transverse transport (TTT) in treating Wagner grade 3-4 type 2 diabetic foot ulcers and analyze dynamic changes in immunoglobulin levels. METHODS: The clinical data of 68 patients with Wagner grade 3-4 type 2 diabetic foot ulcers treated with TTT between May 2022 and September 2023 was retrospectively analyzed. The cohort included 49 males and 19 females, aged 44-91 years (mean, 67.3 years), with 40 Wagner grade 3 and 28 grade 4 ulcers. The duration of type 2 diabetes ranged from 5 to 23 years, with an average of 10 years. The number of wound healing cases, healing time, amputation cases, death cases, and complications were observed and recorded. Serum samples were collected at 6 key time points [1 day before TTT and 3 days, 7 days (the first day of upward transverse transfer), 14 days (the first day of downward transverse transfer), 21 days (the first day after the end of transfer), 36 days (the first day after the removal of the transfer device)], and the serum immunoglobulin levels were detected by flow cytometry including immunoglobulin G (IgG), IgA, IgM, IgE, complement C3 (C3), C4, immunoglobulin light chain κ (KAP), immunoglobulin light chain λ (LAM). RESULTS: All the 68 patients were followed up 6 months. Postoperative pin tract infection occurred in 3 cases and incision infection in 2 cases. Amputation occurred in 5 patients (7.4%) at 59-103 days after operation, and 8 patients (11.8%) died at 49-77 days after operation; the wounds of the remaining 55 patients (80.9%) healed in 48-135 days, with an average of 80 days. There was no recurrence of ulcer, peri-osteotomy fracture, or local skin necrosis during follow-up. The serum immunoglobulin levels of 55 patients with wound healing showed that the levels of IgG and IgM decreased significantly on the 3rd and 7th day after operation compared with those before operation ( P<0.05), and gradually returned to the levels before operation after 14 days, and reached the peak on the 36th day. IgA levels continued to decrease with time, and there were significant differences at all time points when compared with those before operation ( P<0.05). The level of IgE significantly decreased at 21 days after operation compared with that before operation ( P<0.05), while it was higher at other time points than that before operation, but the difference was not significant ( P>0.05). The level of C3 showed a clear treatment-related increase, which was significantly higher on the 7th, 14th, and 21st days after operation than that before operation ( P<0.05), and the peak appeared on the 14th day. The change trend of C4 level was basically synchronous with that of C3, but the amplitude was smaller, and the difference was significant at 7 and 14 days after operation compared with that before operation ( P<0.05). There was no significant difference in KAP/LAM between different time points before and after operation ( P>0.05). CONCLUSION TTT can accelerate wound healing, effectively treat diabetic foot ulcer, and reduce amputation rate, and has definite effectiveness. The potential mechanisms of TTT in the treatment of diabetic foot ulcers include the dynamic regulation of IgG, IgA, IgM, and IgE levels to balance the process of inflammation and repair, and the periodic increase of C3 and C4 levels may promote tissue cleaning, angiogenesis, and anti-infection defense.
Humans ; Male ; Female ; Middle Aged ; Aged ; Diabetic Foot/immunology* ; Wound Healing ; Adult ; Retrospective Studies ; Aged, 80 and over ; Treatment Outcome ; Tibia/transplantation* ; Diabetes Mellitus, Type 2/complications* ; Amputation, Surgical ; Immunoglobulins/blood* ; Immunoglobulin G/blood*

Objective:To separate and purify the polysaccharides from Polygonatum filipes,characterize their primary structure and investigate the immunomodulatory effects on RAW264.7 macrophages.Methods:Crude polysaccharides from Polygonatum filipes were extracted by ultrasound assisted method,then Polygonatum filipes polysaccharides(CSPFPs)were obtained after elimination of the proteins with combined papain-Sevag method.The total sugar content was determined by phenol-sulfuric acid method.Structures of CSPFPs were analyzed by fourier transform infrared spectroscopy(FT-IR),high performance gel permeation chromatography(HPGPC)and high performance liquid chromatography(HPLC).Effects of CSPFPs on cell viability,pinocytic activity,TNF-α secretion,MAPK and NF-κB signaling pathways of RAW264.7 cells were explored by MTT,Neutral red,ELISA and Western blot,respectively.Results:Extraction rate of CSPFPs by ultrasound-assisted method was 41.61%,which contained total sugar content of 94.00%.CSPFPs with Mw of 3 125 Da was composed of arabinose(1.85%),galactose(6.14%),glucose(56.41%)and mannose(35.60%).The in vitro experiments showed that CSPFPs were non-cytotoxic and enhanced the pinocytic activity,TNF-α secretion and phosphorylation levels of p38,ERK,JNK,p65,IκB and IKK,indicating the activation of MAPK and NF-κB signaling pathways under the concentra-tion of 2.5～200 μg/ml.Conclusion:The ultrasound-assisted method can efficiently isolate CSPFPs with immunomodulatory activity,which provides basic data for the development and application of CSPFPs as an immunostimulant.

Objective:To separate and purify the polysaccharides from Polygonatum filipes,characterize their primary structure and investigate the immunomodulatory effects on RAW264.7 macrophages.Methods:Crude polysaccharides from Polygonatum filipes were extracted by ultrasound assisted method,then Polygonatum filipes polysaccharides(CSPFPs)were obtained after elimination of the proteins with combined papain-Sevag method.The total sugar content was determined by phenol-sulfuric acid method.Structures of CSPFPs were analyzed by fourier transform infrared spectroscopy(FT-IR),high performance gel permeation chromatography(HPGPC)and high performance liquid chromatography(HPLC).Effects of CSPFPs on cell viability,pinocytic activity,TNF-α secretion,MAPK and NF-κB signaling pathways of RAW264.7 cells were explored by MTT,Neutral red,ELISA and Western blot,respectively.Results:Extraction rate of CSPFPs by ultrasound-assisted method was 41.61%,which contained total sugar content of 94.00%.CSPFPs with Mw of 3 125 Da was composed of arabinose(1.85%),galactose(6.14%),glucose(56.41%)and mannose(35.60%).The in vitro experiments showed that CSPFPs were non-cytotoxic and enhanced the pinocytic activity,TNF-α secretion and phosphorylation levels of p38,ERK,JNK,p65,IκB and IKK,indicating the activation of MAPK and NF-κB signaling pathways under the concentra-tion of 2.5～200 μg/ml.Conclusion:The ultrasound-assisted method can efficiently isolate CSPFPs with immunomodulatory activity,which provides basic data for the development and application of CSPFPs as an immunostimulant.

Objective:To investigate the clinical effect of middle and lower facial rhytidectomy by lifting the prolapsed buccal fat pad using a consecutive suspensions in a dragnet fashion.Methods:from December 2016 to October 2019, 42 female patients aged 46 to 65 with aging faces and prolapsed buccal fat pads were treated with multiple suspension method. The incision was the classic temporal to peri-auricular incions. After the skin flap and superficial musculoaponeurotic system(SMAS) flap was elevated. The suspending stitches were arranged with 5 lines from the lateral edge of orbicularis oris muscle to the level of zygomatic process to lift the sagging buccal fat pad and achieve facial rejuvenation. The short and long term complicationsas well as post-operative satisfaction rate were also investigated.Results:After 9-12 months of follow-up, the facial aging characteristics were significantly improved, especially sagging mandibular bag and loose perioral skin. The volume of middle face was restored with natural contour. Post-operative complications included local facial depression (2 patients), slight asymmetry (1 patient) and mild tactile abnormalities (1 patient). Satisfaction survey showed that 28 patients were very satisfied, 12 were satisfied and 2 were dissatisfied. The subjective satisfaction rate was 95.2% (40/42). There were no serious complications such as facial nerve injury or flap necrosis.Conclusions:This technique has a good outcome combined with conventional rhytidectomy, as it can achieve good effect of rejuvenationin the middle and lower face.

Objective:To investigate the clinical effect of middle and lower facial rhytidectomy by lifting the prolapsed buccal fat pad using a consecutive suspensions in a dragnet fashion.Methods:from December 2016 to October 2019, 42 female patients aged 46 to 65 with aging faces and prolapsed buccal fat pads were treated with multiple suspension method. The incision was the classic temporal to peri-auricular incions. After the skin flap and superficial musculoaponeurotic system(SMAS) flap was elevated. The suspending stitches were arranged with 5 lines from the lateral edge of orbicularis oris muscle to the level of zygomatic process to lift the sagging buccal fat pad and achieve facial rejuvenation. The short and long term complicationsas well as post-operative satisfaction rate were also investigated.Results:After 9-12 months of follow-up, the facial aging characteristics were significantly improved, especially sagging mandibular bag and loose perioral skin. The volume of middle face was restored with natural contour. Post-operative complications included local facial depression (2 patients), slight asymmetry (1 patient) and mild tactile abnormalities (1 patient). Satisfaction survey showed that 28 patients were very satisfied, 12 were satisfied and 2 were dissatisfied. The subjective satisfaction rate was 95.2% (40/42). There were no serious complications such as facial nerve injury or flap necrosis.Conclusions:This technique has a good outcome combined with conventional rhytidectomy, as it can achieve good effect of rejuvenationin the middle and lower face.

Objective To explore clinical and radiological outcomes of treating displaced fractures of proximal clavicle by open reduction and internal fixation with an inverted anatomic locking plate for distal clavicle.Methods From August 2013 to August 2015,12 patients with displaced fracture of proximal clavicle were treated in our hospital by open reduction and internal fixation with an inverted anatomic locking plate for distal clavicle.They were 11 men and one woman,with an average age of 43.5 years (range,25 to 62 years).There were 9 fresh and 2 old fractures.According to the Edinburgh classification,10 fractures were classified as type 1B1 and 2 as type 1B2.After fixation,the 180° inverted plate on the ipsilateral side was placed on the superior aspect of proximal clavicle.The medial fragment was fixed with 2 to 4 pieces of 2.7 mm multidirectional locking screw and the lateral fragment with 2 to 3 pieces of 3.5 mm locking screw.X-ray and CT were performed to assess union,delayed union,nonunion,and hardware failure.Functional outcomes were assessed by Constant-Murley scores and Disabilities of the Arm,Shoulder and Hand (DASH) scores at final follow-ups.Results There were no significant neurovascular injuries intraoperatively.All patients were followed up for an average of 15.6 months (range,12 to 24 months).All fractures healed after an average of 14.3 weeks (range,8 to 24 weeks).At final follow-ups,the mean Constant-Murley score was 96.0 points (range,84 to 100 points) and the mean DASH score 1.9 points (range,0 to 14.8 points).There were no such significant complications as infection,reduction loss or implant failure.Conclusion Displaced fractures of proximal clavicle may be treated with an inverted anatomic locking plate for distal clavicle on the ipsilateral side because of rigid fixation,fine stability and good chance for early rehabilitation.

Objective To discuss the surgical indications,relative merits and clinical outcomes of anterior reconstruction plate fixation for treating unstable posterior pelvic ring injuries.MethodsA retrospective study was done on clinical data of 36 patients with unstable posterior pelvic ring injuries treated with anterior reconstruction plate fixation from August 2004 to July 2010 and followed up for minimum one year.There were 25 males and 11 females,at mean age of 35.8 years ( range,13-62 years).There were two patients with anterior dislocation of the sacroiliac joint and 34 with posterior dislocation.According to Tile classification,there were four patients with type B fractures ( B1:3,B2:1 ) and 32 with type C fractures (C1-1:17,C1-2:12,C2:2,C3:1 ).Results All patients were followed up for average 2.3 years ( range,1-6 years).Fat liquefaction and superficial infection were founded in two patients who were cured by dressing change and frequent but low-dose blood transfusion.Eight patients were subjected to iatrogenic lateral femoral cutaneous nerve injury.Meanwhile,five of them was recovered after treatment with neurotrophic drugs,but there were still three patients leaving lateral thigh numbness.One patient had L5 nerve root injury due to pull force,and was recovered after three months of neurotrophic drug therapy.According to Matta and Tometta criteria,the reduction results were excellent in 23 patients,good in 11 and fair in four,with excellence rate of 94％.No reduction loss or implant failure occurred.According to Majeed scoring system,the clinical outcomes were excellent in 17 patients,good in 14,fair in four and poor in one,with excellence rate of 86％.Of the seven patients pre-operatively associated with sacral plexusinjury,three obtained full recovery,two got partial recovery and two were free from recovery.Conclusion The anterior reconstruction plate fixation takes advantages of wide surgical indications,simple exposure,low infection rate,satisfactory reduction and solid fixation and may be a main treatment method for unstable posterior pelvic ring injuries.

Objectlve To explore the effect of Qibai Pingfei capsule on the right ventricular hypertrophy index (RVHI)of rats with phlegm and blood stasis of COPD.Methods 60 rats were randomly divided into 6 groups,a control group,a model group,a Ligustrazine group,a Nifedipine group,a high dose Qibai Pingfei capsule group and a low dose Qibai Pingfei capsule group.Composite factors method was adopted to establish phlegm and blood stasis COPD rat model.At the same time of modeling.Qibai Pingfei capsule,Ligustrazine,Nifedipine were also given to these rats.Observed the changes of RVHI in each group.Results RVHI did not show statistic difierence between high dose of the Qibai Pingfei capsule group and the control group(P＞0.05).and between the Nifedipine group and the model group(P＞0.05).RVHI manifested significant diffbrencc between the Ligustrazine group and the low dose Qibai Pingfei capsule group(P＜0.01),and between the Ligustrazine group and the control group(P＜0.01).Conclusion High dose Qibai Pingfei capsule can effectively prevent the right ventricular hypertrophy of model rats with the phlegm and blood stasis of COPD.Ligustrazine has certain effects but not as good as high dose Qibai Pingfei capsule.Nifedipine can not prevent the right ventricular hypertrophy of model rats.

To identify the advantages of modification treated poly (D, L-lactic and glycolic acid) with poly (ethylene glycol) (PLGA/mPEG, PELGA) block copolymer, blood compatibility was evaluated in vitro. Three different proportional block copolymers (LA/GA80: 20, 70: 30, 50: 50) with 15% mPEG were synthesized. According to the international standard organization (ISO10993) and National Standards of P. R. China GB/T 16886, siliconized glass tube was used as a negative control sample, while non-siliconized glass tube as a positive one. Blood compatibility of PELGA was evaluated by hemolytic ratio analysis, platelet adhesion investigation, dynamic clotting time, plasma recalcification time (PRT) measurements, plasma prothrombin time (PT) and clotting time (CT) test. The results revealed that blood compatibility of the synthesized materials was good. Nanoparticles made by this kind of materials might be promising for intravenous use.
Biocompatible Materials ; chemistry ; Drug Carriers ; chemistry ; Drug Delivery Systems ; Lactic Acid ; chemistry ; Materials Testing ; Platelet Adhesiveness ; drug effects ; Polyethylene Glycols ; chemistry ; Polyglycolic Acid ; chemistry

The chemiluminescence (CL) reaction was observed from the synthesized N-tetrahydrobenzothiazolyl imines mixed with acidified potassium permanganate and the emission intensity was significantly enhanced, when the formic acid was added. The fluorescence spectra, CL spectra, UV-VIS absorption spectra and kinetic property of the reaction were investigated. Based on the CL reaction, a flow injection method for the determination of Ntetrahydrobenzothiazolyl imine was developed. The relative standard deviation for eleven replicate injections of 1.0× 10-6 mol/L schiff bases of N-tetrahydrobenzothiazolyl imine was 1.7%, and the detection limit (3σ) was 5.0 ×10-8 mol/L. Mn2+ ,Fe3+ ,Cu2+ ,Ni2+ ,Cr3+ ,Mg2+ ,Zn2+ ,Tl+ ,Bi2+ and Al3+ ions had no effect whilst Ag+ and Fe2+ ions interfered with the determination.