Objective:To investigate the feasibility and clinical efficacy of percutaneous vertebroplasty (PVP) with measured saturated bone cement injection in the treatment of elderly patients with stage Ⅱ Kümmell's disease.Methods:A retrospective analysis was conducted to analyze the clinical data of the 41 elderly patients with stage Ⅱ Kümmell's disease who had been treated at Department of Spinal Orthopedics, Zhengzhou Orthopedic Hospital from June 2017 to June 2023 by PVP with bone cement injection into the intravertebral vacuum cleft. According to the amount of bone cement injected, the patients were divided into a saturated volume group (bone cement injection metered ≥ 150% of the cleft volume preoperatively measured) in which there were 21 cases, 4 males and 17 females, aged (78.4±5.2) years and a conventional volume group (bone cement injection metered was 100% to 120% of the cleft volume preoperatively measured) in which there were 20 cases, 6 males and 14 females, aged (79.5±7.4) years. The operative time, vacuum cleft volume measured, actual volume of bone cement injected, and percentage of bone cement injected were compared between the 2 groups. Visual analogue scale (VAS) for pain and Oswestry disability index (ODI) were compared between preoperation, postoperative 3 days, and the final follow-up in the 2 groups, as well as between the 2 groups. Cement leakage and other complications were documented.Results:The differences in the preoperative general data were not statistically significant between the 2 groups, indicating comparability ( P>0.05). All the 41 elderly patients successfully completed their surgery. Follow-up time was (18.1±3.3) months. The operative time [(39.7±7.5) min], actual volume of bone cement injected [(5.6±0.9) mL], and percentage of bone cement injected (1.8%±0.3%) in the saturated volume group were all significantly greater than those in the conventional volume group [(35.5±4.9) min, (4.4±1.0) mL, and 1.2%±0.1%] ( P<0.05). Postoperatively, the incisions healed completely in all patients, with no such complications as cement-related adverse reactions. Cement leakage occurred in 2 patients in the conventional volume group, leading to lumbar pain or discomfort after activity, which was relieved by cement reinforcement and nail-rod internal fixation. VAS pain scores and ODIs at 3 d postoperatively and at the final follow-up were significantly improved in all patients compared with preoperation ( P<0.05). At the final follow-up, both VAS pain score and ODI in the saturated volume group improved significantly greater than those in the conventional volume group ( P<0.05). None of the patients had complications like cement displacement at the final follow-up. Conclusion:PVP with measured saturated bone cement injection into the intravertebral vacuum clefts is a safe and effective treatment for stage Ⅱ Kümmell's disease in elderly patients, offering a new minimally invasive option.

Objective:To investigate the feasibility and clinical efficacy of percutaneous vertebroplasty (PVP) with measured saturated bone cement injection in the treatment of elderly patients with stage Ⅱ Kümmell's disease.Methods:A retrospective analysis was conducted to analyze the clinical data of the 41 elderly patients with stage Ⅱ Kümmell's disease who had been treated at Department of Spinal Orthopedics, Zhengzhou Orthopedic Hospital from June 2017 to June 2023 by PVP with bone cement injection into the intravertebral vacuum cleft. According to the amount of bone cement injected, the patients were divided into a saturated volume group (bone cement injection metered ≥ 150% of the cleft volume preoperatively measured) in which there were 21 cases, 4 males and 17 females, aged (78.4±5.2) years and a conventional volume group (bone cement injection metered was 100% to 120% of the cleft volume preoperatively measured) in which there were 20 cases, 6 males and 14 females, aged (79.5±7.4) years. The operative time, vacuum cleft volume measured, actual volume of bone cement injected, and percentage of bone cement injected were compared between the 2 groups. Visual analogue scale (VAS) for pain and Oswestry disability index (ODI) were compared between preoperation, postoperative 3 days, and the final follow-up in the 2 groups, as well as between the 2 groups. Cement leakage and other complications were documented.Results:The differences in the preoperative general data were not statistically significant between the 2 groups, indicating comparability ( P>0.05). All the 41 elderly patients successfully completed their surgery. Follow-up time was (18.1±3.3) months. The operative time [(39.7±7.5) min], actual volume of bone cement injected [(5.6±0.9) mL], and percentage of bone cement injected (1.8%±0.3%) in the saturated volume group were all significantly greater than those in the conventional volume group [(35.5±4.9) min, (4.4±1.0) mL, and 1.2%±0.1%] ( P<0.05). Postoperatively, the incisions healed completely in all patients, with no such complications as cement-related adverse reactions. Cement leakage occurred in 2 patients in the conventional volume group, leading to lumbar pain or discomfort after activity, which was relieved by cement reinforcement and nail-rod internal fixation. VAS pain scores and ODIs at 3 d postoperatively and at the final follow-up were significantly improved in all patients compared with preoperation ( P<0.05). At the final follow-up, both VAS pain score and ODI in the saturated volume group improved significantly greater than those in the conventional volume group ( P<0.05). None of the patients had complications like cement displacement at the final follow-up. Conclusion:PVP with measured saturated bone cement injection into the intravertebral vacuum clefts is a safe and effective treatment for stage Ⅱ Kümmell's disease in elderly patients, offering a new minimally invasive option.

Objective:To compare the clinical effects of 4 kinds of neurocutaneous perforator flap with vascular anastomosis for repair of hand and foot wounds.Methods:From January, 2005 to September, 2019, 112 patients with hand and foot wounds were treated, there were 78 cases of fingers, 11 cases of first web, 5 cases of palm, 6 cases of hand and 12 cases of foot. The defect area was 2.0 cm×1.5 cm-21.0 cm×12.0 cm. All 112 cases were repaired by neurocutaneous perforator flaps anastomosed with blood vessels. Types of flap were applied: Radial collateral artery perforator flap (with posterior cutaneous nerve of forearm) in 30 cases. The flap area was 5.0 cm×2.0 cm-13.0 cm×6.0 cm. Superficial peroneal artery flap (without superficial peroneal nerve) anastomosed with blood vessels in 15 cases. The flap area was 2.5 cm×2.0 cm-9.0 cm×6.0 cm. Lateral superficial sural artery perforator flap (with superior sural cutaneous nerve) in 26 cases. The flap area was 2.5 cm×1.8 cm-7.0 cm×5.0 cm. Peroneal artery perforator flap (with middle and lower sural nerve) in 41 cases. The flap was harvested with area of 2.5 cm×1.8 cm-23.0 cm ×14.0 cm to repair the wounds of feet, back of hands, first web, palm and fingers. CTA images were observed in 40 clinical patients, and the occurrence rate of radial collateral artery, superficial peroneal artery, superficial lateral sural artery, and peroneal artery were measured. Anastomosis cutaneous nerve in 97 cases, and no cutaneous nerve anastomosis 15 cases (superficial peroneal artery flap).Results:The peroneal artery perforator flap (41 cases) and radial collateral artery perforator flap (30 cases) were harvested. The incidence of perforator vessels was both 100%, and incidence of superficial sural artery was 80.8% (21/26 cases). In the other 19.2% (5/26 cases), the superficial medial sural artery was replaced by too thin vessels. The utilization rate of superficial peroneal artery was 60.0% (9/15 cases), the other 40.0% (6/15 cases) were converted to peroneal artery perforator flap. All flaps survived except 1 case of superficial perforator flap of lateral sural artery, which underwent necrosis at the distal end and healed after dressing change. One hundred and one cases were followed-up, including 90 cases for repairing soft tissue defects in hands and 11 cases in feet. The followed-up time ranged from 12 to 120 months, with an average of 36.6 months. There were 40 cases with excellent function, 45 cases with good function and 5 cases with fair function. There were 78 cases of cutaneous nerve anastomosis of hand flap, and the sensory function was above S 3 level. There were 12 cases without anastomosis of cutaneous nerve of hand flap, and the sensory function reached S 3 level in 3 cases and S 2 level in 9 cases. In 11 cases, the cutaneous nerve was anastomosed to repair the soft tissue defect of the foot, and the sensory function was above S 3 level. The radial collateral artery perforator flaps were relatively bulky and needed to be treated by fat removal. The other 3 kinds of three flaps were not bulky. Conclusion:The perforating vessels of peroneal artery and radial accessory artery have larger diameter and easy to harvest. The superficial peroneal artery and the lateral superficial sural artery are relatively small in caliber, especially the superficial peroneal artery. Among the 4 kinds of cutaneous nerve nutrient vascular flaps, the radial accessory artery perforator flap was the most bloated. Sensory nerve innervation flaps were found in the upper segment of lateral sural cutaneous nerve, posterior forearm cutaneous nerve and middle and lower segment of sural nerve. The superficial peroneal artery perforator flap was accompanied by superficial peroneal nerve that did not send cutaneous branches into the flap. The upper segment of superficial peroneal nerve was only a passing nerve.

Objective To establish a quantitative method of ferulic acid by semi-bionic extraction ( SBE ) coupled with high performance liquid chromatography ,and compare the validity of ferulic acid in Qibaipingfei capsule by water extraction ( WE) method and SBE method .Methods The separation was carried out on a Welch-C18 column (250mm ×4.6mm,5μm).A mixture of methanol-1%(V/V)acetic acid solution(33.67)was used as the mobile phase at a flow rate of 1.0 mL/min in isocratic elution mode .The column temperature was kept at 35 °C, and the detection wavelength was set at 315 nm.Results The calibration curve was linear ( r =0.999 8, n =6 ) in the range of 0.013 4 ~0.134 0mg/mL of ferulic acid.The recoveries were 98.93% with RSDs of 0.53%. Conclusion On the basis of the advantages of simplicity and good reproducibility ,this method can be used for the determination of ferulic acid ,and also we can concluded that abstraction of Qibaipingfei capsule by SBE is better than WE method.

Objective To optimize the extraction and inclusion process of mixed volatile oil of Rhizoma acori graminei, Fructus alpiniae oxyphyllae and Rhizoma chuanxiong in Huangpu Tongqiao Capsules. Methods With steam distillation method, extraction amount as indicator, the orthogonal experiment was used to optimze the extraction process of volatile oil from three factors such as water amount, soak time and extraction time. With saturated aqueous solution method, co-inclusion compound yield and volatile oil rate as indicators, the orthogonal experiment was used to optimize the inclusion process from three factors such as the proportion of volatile oil and β-CD, inclusion time and inclusion temperature. Results The optimum extraction was:adding eight times amount of water and soak for 2 hours to extract 7 hours. The optimum inclusion process was:the proportion of volatile oil andβ-CD was 1∶10, the inclusion time was 3 hours, the inclusion temperature was 40 ℃. Conclusion Optimal extraction process of oil has higher rate, and the volatile oil inclusion rate of inclusion process was also higher, the process is stable.

Objective To establish the quality standard of Yuling Tea for its quality control. Methods Astragalus, Fructus cnidii L, Schisandra chinensis and Lycii Fructus in Yuling Tea were identified by TLC. The content of Schisandrin was determined by HPLC. Welch Materials C18 column (250 mm×4.6 mm, 5 μm) with mobile phase of methanol-water (70∶30) was used. The detective wavelength was 250 nm. Results The TLC for identification was simple and special. Schisandrin showed a good linear relationship in 0.222-0.222 0 μg, r=0.999 9. The average recovery was 98.96%, and RSD was 0.74%. Conclusion The method can accurately determine the content of Schisandrin in Yuling Tea. It can be used for quality control of the preparation.

Objective To establish a method for determination of chrysophanol,emodin and rhein in Huangzhi capsules.Method Chrysophanol,emodin and rhein in Huangzhi capsules was determined by TLC-scanning with a mixture of n-hexane-ethylacetate-formic acid(30∶10∶0.5) as the developing system.The detection wavelength was 435 nm and 610 nm.Results The calibraction curve of chrysophanol,emodin and rhein was linear in the range of 0.014 65～0.073 25,0.013 35～0.066 75,0.012～0.072 ?g respectively.Conclusion The method was simple,accurate with good repeatability,and suitable for the content determination of chrysophanol,emodin and rhein in Huangzhi capsules.

AIM: To establish variation in flow rates of anthraquinones in Anzhong Tongbian Capsule(Radix et Rhizoma rhei,Radix paeoniae alba,Fructus cannabis and Semen trichosanthis). METHODS: The thin layer chromatographic method was adopted. The anthraquinones compounds from Radix et Rhizoma Rhei in Anzhong Tongbian Capsules were extracted by ultrasound and separated by outspread on silica gel G thin layer,and n-hexane-ethyl acetate-formic acid(30 ∶ 10 ∶ 0. 5)as the developing system,detection wavelength was set at 435 nm and reference wavelength was 610 nm by using CAMAG TLC ScannerⅢ. RESULTS: Anthraquinones was separated well and 5 peaks of emodin,chrysophanol,aloe-emodin,rhein and physcion were ascertained. CONCLUSION: The method is simple and accurate with a good reproducibility and can be used for the quality control for Radix et Rhizoma Rhei in Anzhong Tongbian Capsules.