Objective To discuss the short-term efficacy and safety of primary percutaneous reduction combined with robotic-assisted screw placement for the treatment of Sanders type Ⅲ and Ⅳ calcaneal frac-tures.Methods A total of 52 patients(52 feet)with Sanders type Ⅲ and Ⅳ calcaneal fractures admitted to this hospital from August 2022 to October 2024 were selected as the study subjects.33 patients were treated with robot assisted screw placement(the observation group),including 23 cases of Sanders type Ⅲ patients(4 cases of AC type,16 cases of AB type,3 cases of BC type)and 10 cases of Sanders type Ⅳ patients;19 patients underwent manual screw placement under C-arm X-ray fluoroscopy(the control group),including 14 cases of Sanders type Ⅲ(5 cases of AC type,9 cases of AB type)and 5 cases of Sanders Ⅳ type.The B?hler angle,Gissane angle,calcaneal height,calcaneal width,and calcaneal length were compared between the two groups at 3 and 12 months after surgery.The differences in the time from injury to surgery,intraoperative blood loss,number of intraoperative fluoroscopies,total incision length,operation time,number of screws inserted,num-ber of punctures,hospital stay,fracture healing time,and proportion of tarsal sinus incision-assisted reduction between the two groups were evaluated and compared.The American Orthopedic Foot and Ankle Society(AOFAS)ankle and hindfoot function score,excellent rate of function and visual analog scale(VAS)pain score after surgery were also compared,and the incidence of postoperative complications between the two groups were compared to evaluate safety.Results Both groups of patients were followed up for more than 12 months after surgery.At 3 and 12 months postoperatively,B?hler's angle,Gissane's angle,calcaneal length,calcaneal height,and calcaneal width in both groups showed significant improvements compared to preopera-tive measurements,but there was no statistically significant difference between the two groups(P＞0.05).The intraoperative blooding loss,number of intraoperative fluoroscopies,operation time,and number of punc-tures in the observation group were all lower than those in the control group,and the differences were statisti-cally significant(P＜0.05);There was no statistically significant difference in the time from injury to surger-y,total incision length,number of screws inserted,hospital stay,fracture healing time,proportion of tarsal si-nus incision-assisted reduction,and excellent rate of function between the two groups of patients(P＞0.05).The AOFAS ankle and hindfoot function score of the observation group was higher than that of the control group at 3 months after surgery,and the VAS pain scores in the early postoperative period was lower than that of the control group,the differences were statistically significant(P＜0.05).The incidence of complications such as lower ankle pain,traumatic arthritis,and plantar pain in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Com-pared with manual screw placement,primary percutaneous reduction combined with robotic-assisted screw placement for the treatment of Sanders type Ⅲ and Ⅳ calcaneal fractures is more effective,safe,precise,mini-mally invasive and efficient,with less intraoperative bleeding and lower incidence of complications.

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China

Objective:To explore the clinical efficacy of periosteum-covered iliac crest autografts for treatment of severe osteochondral lesions of talus （OCLTs）.Methods:A retrospective case series study was used to analyze the clinical data of 26 patients with severe OCLTs treated at Zhejiang Armed Police Corps Hospital from January 2013 to October 2019. There were 21 males and 5 females，aged 17-49 years ［（36.3 ± 10.9）years］. All patients were treated using periosteum-covered iliac crest autografts. The visual analogue scale （VAS），American Orthopedic Foot and Ankle Society （AOFAS） ankle-hindfoot score and ankle joint range of motion （ROM） were assessed before operation，6 months after operation and at the last follow-up （≥ 12 months）. The area of talus injury with MRI at the same level was recorded before operation and at the last follow-up. The healing of talus and joint surface was detected with CT at the last follow-up. The healing of the incision and osteotomy site and complications were observed.Results:All patients were followed for 12 to 22 months［（15.1 ± 3.2）months］. The VAS was （2.4 ± 0.9）points and （1.7 ± 0.6）points at postoperative 6 months and at the last follow-up，significantly lower than the preoperative （5.4 ± 1.2）points （ P < 0.01）. Meanwhile，the VAS at the last follow-up was significantly lower than that at postoperative 6 months （ P < 0.01）. The AOFAS ankle-hindfoot score was （71.7 ± 7.8）points and （87.8 ± 6.2） points at postoperative 6 months and at the last follow-up，significantly lower than the preoperative （66.5 ± 7.5） points （ P < 0.01）. Meanwhile，the AOFAS ankle-hindfoot at the last follow-up was significantly lower than that at postoperative 6 months （ P < 0.01）. The ankle ROM was （58.4 ± 5.5）° and （70.0 ± 4.9）° at postoperative 6 months and at the last follow-up，significantly improved when compared to the preoperative （42.3 ± 8.1）° （ P < 0.01）. Meanwhile，the ankle ROM at the last follow-up was significantly improved when compared to that at postoperative 6 months （ P < 0.01）. The area of talus injury with MRI at the same level was 0.67（0.55，0.89）cm 2 at the last follow-up，significantly improved when compared to preoperative 2.64（1.98，3.68）cm 2 （ P < 0.01）. The transplantation had neither obvious defects nor joint surface steps based on CT findings. All surgical incisions were healed by first intention. There were no complications such as incision infection，skin necrosis，nonunion of osteotomy，malunion or severe ankle joint disorder except that 8 patients had residual local subchondral bone?marrow?edema-like?signal?and 2 patients showed delayed healing of medial malleolus osteotomy. Conclusion:For patients with severe OCLTs，periosteum-covered iliac crest autografts can effectively relieve ankle pain，improve ankle function，and reduce the area of injury.

Objective To develope effective TCM antirheumatic drug and provide theoratical basis of establishing TCM effect evaluation system of RA,the effect of modified Guizhishaoyaozhimu Decoction on RA was evaluated by SF-36 questionnaire. Methods Evaluation of 59 cases in a RCT (random control test) study was based on SF-36 questionnaire. Treatment group was given modified Guizhishaoyaozhimu decoction bid,while control group was given MTX 10 mg,one time a week with celecoxib 200 mg,qd. Observation last on 24 weeks and comparing patients’ quality of life was done at the beginning and end point. Results There was significant difference between two groups on improving physical functioning,role-physical,body pain,social function,and role-emotional (P 0.05). Conclusions Modified Guizhishaoyaozhimu decoction has better effect on improve RA patients’ quality of life than MTX.

In order to investigate the effect of nerve growth factor (NGF) on the proliferation of rabbit corneal endothelial cells and epithelial cells, the in vitro cultured rabbit corneal endothelial cells and epithelial cells were treated with different concentrations of NGF. MTT assay was used to examine the clonal growth and proliferation of the cells by determining the absorbency values at 570 nm. The results showed that NGF with three concentrations ranging from 5 U/mL to 500 U/mL enhanced the proliferation of rabbit corneal endothelial cells in a concentration-dependent manner. 50 U/mL and 500 U/mL NGF got more increase of proliferation than that of 5 U/mL NGF did. Meanwhile, 50 U/mL and 500 U/mL NGF could promote the proliferation of the rabbit corneal epithelial cells significantly in a concentration-dependent manner. However, 5 U/mL NGF did not enhance the proliferation of epithelial cells. It was suggested that exogenous NGF can stimulate the proliferation of both rabbit corneal endothelial and epithelial cells, but the extent of modulation is different.
Cell Proliferation/*drug effects ; Cells, Cultured ; Dose-Response Relationship, Drug ; Endothelium, Corneal/*cytology ; Epithelium, Corneal/*cytology ; Nerve Growth Factor/*pharmacology

In order to investigate the effect of nerve growth factor (NGF) on the proliferation of rabbit corneal endothelial cells and epithelial cells, the in vitro cultured rabbit corneal endothelial cells and epithelial cells were treated with different concentrations of NGF.MTT assay was used to examine the clonal growth and proliferation of the cells by determining the absorbency values at 570nm. The results showed that NGF with three concentrations ranging from 5 U/mL to 500 U/mL enhanced the proliferation of rabbit corneal endothelial cells in a concentration-dependent manner.50 U/mL and 500 U/mL NGF got more increase of proliferation than that of 5 U/mL NGF did.Meanwhile, 50 U/mL and 500 U/mL NGF could promote the proliferation of the rabbit corneal epithelial cells significantly in a concentration-dependent manner. However, 5 U/mL NGF did not enhance the proliferation of epithelial cells. It was suggested that exogenous NGF can stimulate the proliferation of both rabbit corneal endothelial and epithelial cells, but the extent of modulation is different.

To study the secretion of epidermic growth factor (EGF) in tears from patients with herpes simplex virus keratitis (HSVK), radio-immunoprecipitation was used to detect the value of EGF in human reflex tears from 40 cases as control group (group A), 49 cases of acute HSVK (group B) and 31 cases of convalescence HSVK (group C). Results showed that the value of EGF in reflex tears from the patients in the group B was obviously increased as compared with that in the group A and group C (P<0.001). The value of EGF in tears in the group C was higher than in group A (P<0.05). It was concluded that the value of EGF in reflex tears from HSVK patients was higher than that from normal people.