Objective:To evaluate the curative effect of hyperbaric oxygen assisting minimally invasive plate osteosynthesis in treating the middle and distal tibia fracture and its influence on the blood supply.Methods:One hundred cases of patients with tibial fractures from January 2016 to December 2018 admitted to the First Department of Ortho Pedics Forth People′s Hospital of Shenyang were selected and randomly divided into control group ( n=50) and observation group ( n=50). The control group was treated with minimally invasive steel plate osteoplasty, and the observation group was treated with hyperbaric oxygen therapy on the basis of the treatment of the control group for 4 consecutive weeks. The pain intensity scores measured by Visual Analog Scale (VAS), skin blood supply at the fracture site, fracture healing and scabbing, bone density, knee/ankle function were compared between the two groups 1 week, 1 month, and 6 months after surgery. Results:One week after surgery, the differences of VAS, fracture healing scores, and bone density between the groups all showed no statistical significance ( P>0.05). One month after surgery, the VAS score, the score of fracture healing and scabbing, and the bone density of the observation group were significantly better than those of the control group ( P<0.05). In the observation group, the incidence of poor blood supply to the skin at the fracture site was 14.0%, which was significantly lower than that of the control group (32.0%) ( P<0.05). The recovery rate of the function of knee and ankle joints was 58.0%, which was higher than that in the control group (38.0%) ( P<0.05). Six months after surgery, the VAS score of the observation group was significantly decreased, and the bone density in the observation group was significantly increased, compared with those of the control group. All differences were statistically significant ( P<0.05). The blood supply to the skin, the fracture healing and scabbing, and the functional recovery of knee and ankle joints of the observation groups were better than those of the control group, but there were no statistical differences( P>0.05). Conclusion:Hyperbaric oxygen assisting minimally invasive plate osteosynthesis in treating the middle and distal tibia fracture could increase the partial pressure of blood oxygen, accelerate the revascularization at the fracture site, reduce local tissue edema and necrosis, promote bone healing, and reduce postoperative pain, which could be used as an auxiliary treatment for the middle and distal tibial fracture.

Objective:To evaluate the curative effect of hyperbaric oxygen assisting minimally invasive plate osteosynthesis in treating the middle and distal tibia fracture and its influence on the blood supply.Methods:One hundred cases of patients with tibial fractures from January 2016 to December 2018 admitted to the First Department of Ortho Pedics Forth People′s Hospital of Shenyang were selected and randomly divided into control group ( n=50) and observation group ( n=50). The control group was treated with minimally invasive steel plate osteoplasty, and the observation group was treated with hyperbaric oxygen therapy on the basis of the treatment of the control group for 4 consecutive weeks. The pain intensity scores measured by Visual Analog Scale (VAS), skin blood supply at the fracture site, fracture healing and scabbing, bone density, knee/ankle function were compared between the two groups 1 week, 1 month, and 6 months after surgery. Results:One week after surgery, the differences of VAS, fracture healing scores, and bone density between the groups all showed no statistical significance ( P>0.05). One month after surgery, the VAS score, the score of fracture healing and scabbing, and the bone density of the observation group were significantly better than those of the control group ( P<0.05). In the observation group, the incidence of poor blood supply to the skin at the fracture site was 14.0%, which was significantly lower than that of the control group (32.0%) ( P<0.05). The recovery rate of the function of knee and ankle joints was 58.0%, which was higher than that in the control group (38.0%) ( P<0.05). Six months after surgery, the VAS score of the observation group was significantly decreased, and the bone density in the observation group was significantly increased, compared with those of the control group. All differences were statistically significant ( P<0.05). The blood supply to the skin, the fracture healing and scabbing, and the functional recovery of knee and ankle joints of the observation groups were better than those of the control group, but there were no statistical differences( P>0.05). Conclusion:Hyperbaric oxygen assisting minimally invasive plate osteosynthesis in treating the middle and distal tibia fracture could increase the partial pressure of blood oxygen, accelerate the revascularization at the fracture site, reduce local tissue edema and necrosis, promote bone healing, and reduce postoperative pain, which could be used as an auxiliary treatment for the middle and distal tibial fracture.

BACKGROUND: Secretion of various neurotrophic factors by Schwann cells plays important roles in neural regeneration. However, the secretion capability is affected by many factors. To seek a feasible method for promoting nerve growth factor secretion by Schwann cells is a key of regeneraion following neurologic defect.OBJECTIVE: To explore the effects of methylprednisolone(solu-medrol) on the secreted function of Schwann cells of cultured rats.METHODS: Schwann cells were isolated and cultured by enzyme digestion method. Cell growth was observed under an inverted phase contrast microscope. Following passage, purity of some Schwann cells was identified using S-100 protein immunity. Other Schwann cells were regulated using cell counting plate into 1×10~9/L, and incubated in a 6-well culture plate (15 wells) for further incubation. Following 4 days of culture, different concentrations of solu-medrol (10~(-3), 10~(-4), 10~(-6), 10~(-8) mol/L) were administrated to the cell, while blank control group (1 well) was given no drug. 24, 48 and 72 hours after administration, reverse trancription-polymerase chain reaction (RT-PCR) was used in the detection of the levels of nerve growth factor mRNA.RESULTS AND CONCLUSION: Number of primarily cultured cells was significantly increased at day 7, and 80% cells were confluent. Subcultured cells were spindle-shaped, with 2 thin long processes, showing positive fluorescence staining. Fibroblasts were round or flat, showing negative reaction of fluorescence staining. Reserve transcription-polymerase chain reaction demonstrated that nerve growth factor number at 72 hours affected by 10~(-8) mol/L radiosone was increased compared with the blank control group and other concentrations and other time points (P < 0.05). Number of nerve growth factor was reduced following treatment of 10~(-3) mol/L radiosone compared with the blank control group and other concentrations (P < 0.05). These results suggested that high concentration of solu-medrol prohibits secreted function of Schwann's cells, but long time and low dosage solu-medrol promotes secreted function of Schwann's cells.