OBJECTIVE: To evaluate the effectiveness of early internal fixation combined with free anterolateral thigh perforator flap (ALTPF) transplantation in the treatment of open ankle fracture-dislocation. METHODS: A retrospective analysis was performed on the clinical data of 13 patients with open ankle fracture-dislocation who were admitted and met the inclusion criteria between January 2021 and May 2024. Among them, there were 9 males and 4 females, with the ages ranging from 23 to 61 years (mean, 45.3 years). Fracture types included 5 cases of simple medial or lateral malleolar fracture-dislocation, 7 cases of bimalleolar (medial and lateral) fracture-dislocation, and 1 case of trimalleolar fracture-dislocation. Additionally, 3 cases were complicated with bone defects (1 medial malleolus defect and 2 lateral malleolus defects). All injuries were classified as type ⅢB according to the Gustilo-Anderson classification for open fractures. The size of wound defects ranged from 7 cm×5 cm to 18 cm×12 cm. The time from injury to surgery was 2-20 hours (mean, 4 hours). All patients underwent emergency thorough debridement upon admission. The fracture-dislocation was temporarily stabilized with an external fixator, and the wound was covered with antibiotic-impregnated bone cement sheets or vacuum sealing drainage. Definitive internal fixation of the fracture and free ALTPF transplantation were performed 5-7 days after the initial emergency procedure. Postoperatively, wound healing, flap survival, and fracture union were monitored. At last follow-up, clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. RESULTS: All 13 patients were followed up 6-24 months (mean, 8.2 months). All flaps survived completely, and all fractures achieved union, with an union time of 3-11 months (mean, 5.5 months). One patient developed a superficial infection at the wound margin, which healed after regular dressing changes and drainage. No internal fixation-related complication (e.g., deep infection, implant loosening, or secondary ankle instability) were observed. At last follow-up, the total AOFAS ankle-hindfoot score was 78.6±13.5, with 3 excellent, 7 good, 2 fair, and 1 poor cases, yielding an excellent and good rate of 76.9%. CONCLUSION Early internal fixation combined with ALTPF transplantation for open ankle fracture-dislocation can shorten the treatment course and maximize the recovery of ankle joint function.
Humans ; Fracture Fixation, Internal/methods* ; Male ; Middle Aged ; Female ; Adult ; Retrospective Studies ; Perforator Flap/transplantation* ; Ankle Fractures/surgery* ; Thigh/surgery* ; Fractures, Open/surgery* ; Treatment Outcome ; Young Adult ; Plastic Surgery Procedures/methods* ; Fracture Dislocation/surgery*

OBJECTIVETo explore the protective effect of electroacupuncture (EA) pretreatment on ovarian function in rats with ovulation induction.

METHODSThirty SD female rats were numbered according to random number table. According to vaginal smear method, rats of estrus were divided into a normal group (10 rats) and cohabitated with male SD rats with the proportion of 1:1. With computer-generated random number, the remaining rats were divided into a model group and an EA group, 10 rats in each one. The model of superovulation was established with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (HCG) in the model group and EA group. Before model establishment and cohabitation, rats in the EA group were treated with EA at "Guanyuan (CV 4)" and "Sanyinjiao (SP 6)", once for 15 min, for consecutive 7 days. Rats in the normal group and model group received no further treatment. The third day 23:00 pm after cohabitation, blood samples in three groups were collected to test the level of estradiol (E₂) and progesterone (P). After the rats were sacrificed, the HE staining method was applied to observe the morphological changes of ovarian tissue; the immunohistochemical method was applied to measure the expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2; the real-time quantitative PCR technique was applied to measure the gene expression of VEGF and VEGFR-2.

RESULTSThe number of ovarian follicle in the EA group was higher than that in the model group and normal group (all P < 0.05); the ratio of corpus luteum size to ovarian size in the EA group was lower than that in the model group (P < 0.01). The ratio of plasma estradiol to progesterone in the EA group tended to be normal group (P < 0.05) and lower than that in the model group (P < 0.01). The protein expression of VEGF and VEGFR-2 in lutein granulosa cell and follicular fluid in the EA group was lower than that in the model group (P < 0.05); gene level of VEGF and VEGFR-2 in ovarian tissue in the EA group was lower than that in the model group (P < 0.05, P < 0.01).

CONCLUSIONEA pretreatment has certain protective effect on ovarian function in rats with ovulation induction, which is likely to be related to regulation of VEGF and its receptor.

Acupuncture Points ; Animals ; Chorionic Gonadotropin ; blood ; Electroacupuncture ; Estradiol ; blood ; Female ; Male ; Ovary ; physiology ; Ovulation Induction ; Pregnancy ; Progesterone ; blood ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

ObjectiveTo investigate the modification method of Cervical Spine Injury Severity Score System and discuss diagnosis and treatment strategy of lower cervical spine injuries.Methods Treatments of lower cervical spine injuries were selected according to the injury severity graded by the modified Moore' s classification system.Conservative therapy could be adopted for the patients with stability quantification rating ＜ 3 points or for the those with stability quantification rating =3 points but without spinal cord or nerve root compression.Surgical treatment was recommendable for the patients with stability quantification rating =3 points and with spinal cord or nerve root compression.Surgical therapy could be required for the patients with stability quantification rating ≥4 points and with risk of lower cervical instability.The higher the stability quantification score implied the stronger the surgical indications.Lower cervical spine injury combined with spine cord or nerve root compression had absolute surgical indications.At the same time,therapies were selected based on patients' other factors.ResultsBased on basic principles of the modified Moore' s classification system together with opinions of the patients and their relatives,14 patients were managed with surgical treatment and 16 with conservative treatment.Among the patients with complete spinal cord injury (Grade A),two patients treated surgically showed no obvious signs of spinal function recovery,but their nerve root irritation symptoms disappeared; the other one patient who needed surgery but received conservative treatment had no change of the spinal cord function and nerve root irritation.The patients with incomplete spinal cord injury (Grades B,C and D) treated surgically obtained certain degree of spine cord function recovery,with their American Spinal Injury Association (ASIA) score raised by 0.5 grade on average.However,the patients who needed surgery but received conservative treatment gained average increase of ASIA score for 0.5 grade.Imaging examination showed that patients without combined spinal injuries obtained interbody fusion after surgery,with normal alignment and height of the cervical vertebra but without presence of vertebral shift or instability. ConclusionsThe modified Moore' s classification system takes patients' spiaal injury condition and other factors into consideration in selection of conservative or surgical treatment,which improves the Cervical Spine Injury Severity Score System to some extent and has prospect of clinical application.

Objective To estimate the clinical value of percutaneous vertebroplasty (PVP)performed on the elderly patients aged 80 years and over with osteoporotic vertebral fractures.Methods Since January 2000, 19 patients aged 80 years and over were treated with PVP, and 17 patients from 60 to 79 years old underwent percutancous kyphoplasty (PKP). Visual analogue scale (VAS) was tested preoperatively and 1 to 7 days, 3 months, 6 months, 1 year and 2 years after operation. The time of radiation, volume of bone cement injection and hospital charges were compared betwecn two procedures. Results Over the 2-year follow-up, there were no significant differences in analgesia effects between thc two groups (P＞0.05). The radiation time of PVP and PKP was (107±37)s and (151±76)s respectively (t=2.24, P＜0.05). The hospital charges of PVP and PKP were ￥(16 124±5850) and ￥(34 265±6655) respectively (t=9.26,P＜0.01). Conclusions PVP is better than PKP for treating osteoporotic compression fractures in the elderly patients over 80 years, because of the former's simplicity and efficiency.

Objective To observe any changes in spinal cord hemodynamics after spinal cord injury and to investigate their mechanism. Methods Twenty female Sprague-Dawley rats were divided into a control group and a moderate injury group,10 rats in each group.A rat model of spinal cord injury caused by moderate compression was established using Nystrom's method.Changes in the velocity and volume of blood flow and in the diameters of vessels of the spinal cord were monitored for 6 hours using laser speckle imaging. Results No changes in the velocity or volume of blood flow or in the diameter of vessels were observed in the control group,but all of these indices diminished significantly in the injury group. Conclusions Laser speckle imaging can be used to monitor changes in spinal cord hemodynamics.Such changes after acute spinal cord injury indicate progressive post-injury ischemia.The occlusion of veins may be an important contributor to post-injury ischemia.

To prepare poly(lactic acid/glycolic acid/ asparagic acid-co- polyethylene glycol) (PLGA-[ASP-PEG]) and examine the cellular biocompatibility. PLGA-[ASP-PEG] was obtained by bulk ring-opening copolymerization method, examined by infrared spectrometry (IR) and 1H nuclear magnetic resonance spectroscopy (1H NMR). Bone marrow stromal cells(BMSCs) were cultured with PLGA-[ASP-PEG] (experiment gruop) and PLGA (control group) in vitro respectively, and were observed by phase-contrast microscopy and scanning electron microscopy. The resuls showed that PLGA-[ASP-PEG] was obtained and proved by IR and 1H NMR. The BMSCs of the experiment group could well attach to and extend on the surface of the PLGA-[ASP-PEG], and could proliferate and secrete better extracellular matrix, compared with control. The PLGA-[ASP-PEG] has good cellular a biocompatibility. It can be used as a biomaterial for bone tissue engineering.
Aspartic Acid ; chemistry ; Biocompatible Materials ; Bone Matrix ; cytology ; Lactic Acid ; chemistry ; Mesenchymal Stromal Cells ; cytology ; Polyesters ; Polyethylene Glycols ; chemistry ; Polyglycolic Acid ; chemistry ; Polymers ; chemistry ; Tissue Engineering

Object To study the protective effect of Rodobryum roseum (Hedw) Limpr. on acute myocardial ischemia. Methods Rat acute myocardial ischemia models were prepared by ligating their left coronary arteries. Changes of their S-T segment was observed on lead Ⅱ dynamic ECG. Degree of ischemia was assessed by the extent of S-T segment elevation. Lactic dehydrogenase (LDH), creative phosphokinase (CPK), superoxide dismutase (SOD) and malondialdehyde (MDA) were determined at the same time. Results R. roseum can significantly alleviate S-T segment elevation, being most evident at the dose of 2 g/kg (P