Objective To explore the influencing factors on foot function recovery after distraction device-assisted repositioning of small incisions treatment for Sanders Ⅱ and Ⅲ calcaneal fractures,and to provide guidance for timely clinical interventions.Methods A retrospective analysis was conducted on 80 patients with Sanders type Ⅱ and Ⅲ calcaneal fractures admitted to the People's Hospital of Bozhou from January 2021 to June 2023.Data were collected using a general information questionnaire,the hospital's electronic medical record system,the visual analog scale(VAS),the Marland foot function scale(MFS),the perceived social support scale(PSSS),and the perceived stress scale(PSS).The influencing factors of postoperative foot function recovery were analyzed using univariate factor analysis,multivariate linear regression,and structural equation modeling.Results The MFS scores of 80 patients at 6 months post-operation were significantly higher than preoperative scores(P＜0.001).The rates of excellent,good,fair,and poor foot function at 6 months post-operation were 56.3％,31.3％,10.0％,and 2.5％,respectively.Univariate analysis revealed significant differences in MFS scores based on different ages,time to start full weight-bearing exercise,bone mineral density,surgical timing,body mass index(BMI),postoperative VAS score,PSSS score,PSS score,and the presence of postoperative peroneal muscle spasm and peroneal muscle tendon adhesion(P＜0.05).Multivariate linear regression identified age,time to start full weight-bearing exercise,surgical timing,BMI,postoperative fibular muscle spasm,postoperative fibular muscle tendon adhesion,postoperative VAS score,PSSS score,and PSS score as significant factors affecting foot function recovery(P＜0.05).Structural equation modeling indicated that age,time to start full weight-bearing exercise,bone density,operative timing,BMI,postoperative peroneal muscle spasm,postoperative peroneal tendon adhesion,and pain severity directly influenced postoperative foot functional recovery.Additionally,psychological stress not only directly affected postoperative foot functional recovery but also indirectly influenced it through the mediating effect of social support.Conclusions Foot function recovery after surgery for Sanders type Ⅱ and Ⅲ calcaneal fractures is influenced by multiple factors.Psychological stress not only directly affects the recovery of foot function after surgery,but also mitigates the harm to foot function through social support.

OBJECTIVETo measure the correlative parameters of vertebral pedicles from L₁ to S₁ by CT scan in the patients with thoracolumbar kyphosis secondary to ankylosing spondylitis(AS) and disc degenerative disease(DDD), and analyze their anatomical difference in order to provide the selection and placement of pedicle screw during operation.

METHODSThe clinical data of 30 male AS patients (AS group) with the mean age of(35.7±9.5) years (ranged, 23 to 51) and 30 male DDD patients (DDD group) with the mean age of(52.4±8.9) years(ranged, 39 to 64) underwent surgery in our institution from March 2012 to November 2014 were analyzed. The CT scans of lumbar and sacrum were performed before surgery. The parameters of vertebral pedicle from L₁ to S₁ were measured and compared, including pedicle width (PW), pedicle screw path length (PL), pedicle height (PH), pedicle transverse angle (EA), and pedicle inclined angle (FA). Paired sample t-test was used to detect the divergence in the above-mentioned data between left and right sides. In addition, results between two groups were compared using independent sample t-test.

RESULTSThe study showed that a gradual increase in the average pedicle width both AS group and DDD group from L₁ to S₁. The average PW of AS group was bigger than DDD group in L₅ and S₁(<0.05), it was(16.47±2.66) mm and (21.76±2.97)mm vs. (14.51±2.11)mm and (18.87±2.14) mm respectively;the average PL of DDD group was smaller than AS group from L₁ to S₁(<0.05); the both maximum of PL were in L₃ segment; the average EA of AS group was smaller than DDD group from L₁ to S₁; the average FA of AS group was significantly smaller than DDD group from L₃ to S₁, (<0.05), was(-2.88±10.24)°, (-7.88±10.22)°, (-7.70±10.40)°, (-5.15±10.25)° vs. (4.05±2.21)°, (7.79±4.38)°, (7.07±3.21)°, (12.62±3.21)°, respectively.

CONCLUSIONSIncreasing the strength of internal fixation is feasible to insert the larger and bigger pedicle screws in low lumbar and S₁ among AS patients, while the EA should be decreased properly and the direction on the sagittal plane should be adjusted.

BACKGROUNDTraditional Chinese medicine has been used widely for many years in China to treat acute pancreatitis. We have investigated the effects of Dachengqi decoction on intestinal mucosal permeability and outcome in patients with severe acute pancreatitis (SAP).

METHODSForty patients with sustained SAP that required admission to the surgical intensive care unit were enrolled prospectively in the study. All of these patients were divided randomly into the Dachengqi decoction group (n = 20) and control group (n = 20) on admission. Intestinal permeability was assessed by measuring absorption of two metabolically inert markers, lactulose (L) and mannitol (M), which were administered orally. Serum concentrations of endotoxin (lipopolysaccharide, LPS) and the ratio of lactulose to mannitol in urine (L/M) were detected in all patients.

RESULTSCompared with those in the control group, urinary L/M ratio decreased significantly in the Dachengqi decoction group on the 7th day after admission (P = 0.001). Also, serum concentrations of LPS were reduced on the 5th and 7th day after admission (P = 0.006, P = 0.008, respectively). Incidence of multiple organ dysfunction syndrome (MODS) and pancreatic infection was significantly lower in the Dachengqi decoction group compared with those in the control group (P = 0.038,P = 0.025, respectively).

CONCLUSIONDachengqi decoction may promote the recovery of intestinal mucosal permeability and decrease the incidence of MODS and pancreatic infection in patients with SAP.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-6 ; metabolism ; Intestinal Mucosa ; drug effects ; metabolism ; pathology ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Pancreatitis ; drug therapy ; metabolism ; pathology ; Tumor Necrosis Factor-alpha ; metabolism ; Young Adult