BACKGROUND:Ankle fracture complicated with deltoid ligament injury is clinically common,and one stage repair of deltoid ligament with internal fracture fixation has gradually become a main therapeutic method,which can significantly reduce the long-term complications of ankle joint.In recent years,new progress has been made in anatomical structure characteristics and dynamic biomechanical research of deltoid ligament,thus greatly improving repairing techniques for injury in the deep layer of deltoid ligament,but there are still some controversies.OBJECTIVE:To explore the clinical efficacy of suture anchor and medial malleolus repair in the treatment of ankle joint fractures with the deep layer of deltoid ligament.METHODS:A total of 56 patients with ankle joint fractures and complete fracture of the deep and superficial layer of deltoid ligament treated in Affiliated Haikou Hospital,Xiangya School of Medicine,Central South University from January 2017 to January 2022 were selected,and they were divided into two groups according to different treatment methods in repairing the deep layer of deltoid ligament with suture anchor:suture anchor repair group(n=32)and medial malleolus repair group(n=24).The medial clear space of ankle joint and American Orthopedic Foot and Ankle Society Score of patients in the two groups were evaluated before and after operative treatment.RESULTS AND CONCLUSION:(1)All the 56 patients finished the surgery smoothly and were followed up for more than 12 months after operation.Their ankle fracture healed,and the time for fracture healing was 8-12 weeks,with a mean of 10.5 weeks.(2)The medial clear space of ankle joint in the two groups 12 months after operation was remarkably narrower than that before operation,and the difference was statistically significant(P＜0.001).The medial clear space of ankle joint in the two groups maintained a normal range 12 months after operation,and there was no statistically significant difference between the two groups(P＞0.05).(3)The AOFAS scale of patients in the two groups 6 and 12 months after operation was obviously bigger than that before operation(P＜0.001),but there was no statistically significant difference in the American Orthopedic Foot and Ankle Society Score of patients between the two groups at corresponding time points(P＞0.05).(4)It is concluded that both suture anchor and medial malleolus repair in the treatment of injury in the deep layer of deltoid ligament can recover the medial clear space of ankle joint,effectively keep the stability of ankle,and thus achieve good clinical efficacy.

BACKGROUND:Ankle fracture complicated with deltoid ligament injury is clinically common,and one stage repair of deltoid ligament with internal fracture fixation has gradually become a main therapeutic method,which can significantly reduce the long-term complications of ankle joint.In recent years,new progress has been made in anatomical structure characteristics and dynamic biomechanical research of deltoid ligament,thus greatly improving repairing techniques for injury in the deep layer of deltoid ligament,but there are still some controversies.OBJECTIVE:To explore the clinical efficacy of suture anchor and medial malleolus repair in the treatment of ankle joint fractures with the deep layer of deltoid ligament.METHODS:A total of 56 patients with ankle joint fractures and complete fracture of the deep and superficial layer of deltoid ligament treated in Affiliated Haikou Hospital,Xiangya School of Medicine,Central South University from January 2017 to January 2022 were selected,and they were divided into two groups according to different treatment methods in repairing the deep layer of deltoid ligament with suture anchor:suture anchor repair group(n=32)and medial malleolus repair group(n=24).The medial clear space of ankle joint and American Orthopedic Foot and Ankle Society Score of patients in the two groups were evaluated before and after operative treatment.RESULTS AND CONCLUSION:(1)All the 56 patients finished the surgery smoothly and were followed up for more than 12 months after operation.Their ankle fracture healed,and the time for fracture healing was 8-12 weeks,with a mean of 10.5 weeks.(2)The medial clear space of ankle joint in the two groups 12 months after operation was remarkably narrower than that before operation,and the difference was statistically significant(P＜0.001).The medial clear space of ankle joint in the two groups maintained a normal range 12 months after operation,and there was no statistically significant difference between the two groups(P＞0.05).(3)The AOFAS scale of patients in the two groups 6 and 12 months after operation was obviously bigger than that before operation(P＜0.001),but there was no statistically significant difference in the American Orthopedic Foot and Ankle Society Score of patients between the two groups at corresponding time points(P＞0.05).(4)It is concluded that both suture anchor and medial malleolus repair in the treatment of injury in the deep layer of deltoid ligament can recover the medial clear space of ankle joint,effectively keep the stability of ankle,and thus achieve good clinical efficacy.

Objective To constructan eukaryotic expression recombinant plasmid named pEGFP-N2-PRNP .Methods Total RNA was extracted from alzheimer (AD) disease peripheral blood ,and the PRNP gene was amplified by reverse transcription-poly-merase chain reaction(RT-PCR) .By using gene recombination technique ,human PRNP cDNA was inserted into retroviral vector pEGFP-N2 .The recombinant plasmid was identified by a pair of specified primers containing the restriction sites of Xho Ⅰ and EcoRⅠ .Results The PRNP gene could be obtained by RT-PCR ,the recombinant plasmid was identified by restriction endonucle-ase analysis ,PCR and sequence analysis ,and the expression vector pEGFP-N2-PRNP ,which could be stably expressed in SH-SY5Y cells .Conclusion The recombinant plasmid pEGFP-N2-PRNP is constructed successfully ,Which offers a basic for the further re-search on PRNP biological fuction .

Objective To investigate the complications and appropriate managements. Methods 109 cases were treated with intramedullary interlocking nails. 81 cases were simple femoral shaft fratures and 28 cases were combined with subtrochanteric fractures. Results Distal nailing failure in 18 patients(2 distal nails unlocked in 1 cases,1 nail unlocked in 15 cases,nails were loosened and exited in 1 case,1 nail breakage in 1 case). Split of fracture ended in 3 cases. Delayed union in 16 cases,nonunion in 1 case. Flexion restriction of knee joint in 20 cases. Broken of main nail in 2 cases. Conclusion Using the intramedtllary interlocking nails to treat femoral shaft fractures had deftnite effect. To avoid the complications, choosing suitable nails preoperative, standard operation, timely and scientific rehabilitation postoperation are necessary.