OBJECTIVE: To explore the effectiveness of the flexor digitorum longus (FDL) transfer combined with single-bundle spring ligament reconstruction and medial displacement calcaneal osteotomy in the treatment of stage ⅠAB progressive collapsing foot deformity (PCFD). METHODS: Between January 2019 and September 2023, 19 patients (19 feet) with stage ⅠAB PCFD were treated with FDL transfer combined with single-bundle spring ligament reconstruction and medial displacement calcaneal osteotomy. There were 11 males and 8 females, aged 18 to 60 years, with an average age of 45.5 years. Nine cases were on the left foot and 10 cases on the right foot. The disease duration was 9-21 months, with an average of 12.3 months. Postoperatively, the effectiveness was evaluated by visual analogue scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Tegner score. Based on X-ray films, the talonavicular coverage angle (TNCA), talus-first metatarsal angle (T1MT), Meary angle, and pitch angle were measured. The plantar pressure parameters of the foot were measured by the Footscan plantar pressure measurement system, including peak pressure and load of the forefoot, midfoot, and hind foot. The patients' satisfaction with the surgical outcome was evaluated. RESULTS: All 19 surgeries were successfully completed. One patient had poor incision healing after operation, while the incisions of the remaining patients healed by first intention. All patients were followed up 12-28 months (mean, 16.8 months). At last follow-up, the VAS score significantly decreased compared with that before operation, and the AOFAS score and Tegner score significantly increased ( P<0.05). Radiological measurements showed that the TNCA, T1MT, Meary angle, and Pitch angle all significantly improved compared with those before operation ( P<0.05). Plantar pressure tests indicated that the peak pressures of the forefoot and midfoot significantly reduced compared with those before operation ( P<0.05), while the peak pressure of the hind foot showed no significant change ( P>0.05). The forefoot load significantly increased and the midfoot load decreased compared with those before operation ( P<0.05), while the hind foot load showed no significant change ( P>0.05). The total satisfaction rate of patients with the surgical outcome (very satisfied+satisfied) reached 84.2% (16/19). CONCLUSION The FDL transfer combined with single-bundle spring ligament reconstruction and medial displacement calcaneal osteotomy can effectively correct the stage ⅠAB PCFD, improve the abnormal distribution of plantar pressure and load, alleviate foot pain symptoms, and improve foot movement function. The patient's satisfaction is high. However, the long-term effectiveness still needs to be further observed and clarified.
Humans ; Female ; Male ; Osteotomy/methods* ; Adult ; Middle Aged ; Calcaneus/surgery* ; Young Adult ; Adolescent ; Tendon Transfer/methods* ; Treatment Outcome ; Plastic Surgery Procedures/methods* ; Foot Deformities/surgery* ; Ligaments, Articular/surgery*

Objective To evaluate the relationship between preoperative MRI characteristics and the perioperative outcomes of microvascular decompression in primary trigeminal neuralgia. Methods To analyze the relationship between preoperative MRI characteristics and the perioperative outcomes in 103 primary trigeminal neuralgia patients with micro-vascular decompression in Nanfang Hospital. The MRI features such as the ratio of CPA area, TGN cross-sectional area and TGN length was evaluated together with the TGN oppression distance, the position of TGN, the position of basilar ar-tery and the type of offending vessel as well as the outocmes including complete disappearance, temporary remission and ineffectiveness. Results Univariate analysis showed that the oppression orientation (P=0.017), oppression distance (P<0.001), offending vascular type (P=0.016), TGN cross-sectional area ratio (P<0.001) were the influencing factors of periop-erative outcomes. Logistic regression analysis showed that the offending vascular type (P=0.002)and TGN cross-sectional area ratio (P=0.020) were the main predictive factors of perioperative outcomes of microvascular decompression. Conclu-sions Preoperative thin slice MRI scanning showed that the offending artery, non-atrophy nerve roots, far distance from op-pression point to brainstem may be the favorable factors of perioperative outcomes of microvascular decompression.

Objective To investigate Nuclear factor-κB (NF-κB) expression in tumor associated inflammation in patients with adamantinomatous craniopharyngima..Methods Fifty-four patients (31 male and 23 female) with craniopharyngioma from 3 to 66 years of age were recruited from May 2004 to March 2006.NF-κB and Osteopontin (OPN) expression in human craniopharyngiomas were detected using immunohistochemical staining.High-sensitivity C-reactive protein (hs-CRP), a systemic marker of inflammation, was examined in patients' tumor hydatid fluid, cerebrospinal fluid and serum.Results NF-κB expression was significantly increased in the adamantinomatous craniopharyngioma.Spearman;s correlation analysis demonstrated that NF-κB expression was associated with OPN expression.The hs-CRP level was also increased in the tumor hydatid fluid (4.28±0.90 mg/mL), cerebrospinal fluid (0.035±0.006 mg/mL) and serum (1.72±0.54 mg/mL) in patients with adamantinomatous craniopharyngioma.Conclusions NF-kappa B is closely associated with tumor associated inflammation which further mediates adhesion of tumor to surrounding important structures in patients with adamantinomatous craniopharyngioma.

Objective To establish a method for amplification of immature dendritic cells(DC) from murine bone marrow in vitro and investigate correlations between maturation degree of DC and varying dosages of granulocyte-macrophage-colony stimulating factor(GM-CSF).Methods Dendritic cells from murine bone marrow were cultured with different dosages of rm GM-CSF.The suspension cells were examined with scanning electronic microscope,and the non-sensitized T lymphocyte proliferation was observed by mixed lymphocyte reaction.Results DC cultured in lower dosage of rmGM-CSF(GMlow DC) exhibited typical characteristics of DC,and had immature characteristics in cell phenotype and cell functions with high expression of CD11c and low expression of CD80,CD86 and MHC II on the surface of the cells.The ability of GmlowDC to stimulate the proliferation of non-sensitized T lymphocyte in vitro was weaker than that of GmhighDC.Conclusions The methods of immature DCs culturing establised by allthors was feasible.The dosage of rm GM-CSF has a direct relationship with the maturation degree of DC.