Objective To explore the clinical efficacy of modified anteromedia approach with superior extensor retinaculars and traditional anteromedia combined with posterolateral approach in the treatment of Rüedi-Allg?wer type Ⅲ Pilon fractures.Methods In this study selected 56 patients with Rüedi-Allg?wer type Ⅲ Pilon fractures treated in our hospital from January 2020 to January 2022,all of whom met the inclusion and exclusion criteria,27 in the experimental group and 29 in the control group.Both groups underwent open reduction and internal fixation of Pilon fractures.The experimental group used a modified anteromedial approach to preserve the supraspinatus,while the control group used a traditional anteromedial combined with posterolateral approach to cut off the supraspinatus.The general clinical data,operation time,intraoperative blood loss,postoperative drainage volume,fracture reduction quality,early pain VAS score,complications and ankle function evaluation of the experimental group and the control group were compared in detail,and the early clinical efficacy of the two surgical methods was analyzed and compared.Results There were no significant differences in age,gender,body mass index(BMI),complications,injury mechanism and the time from admission to operation between the experimental group and the control group(P>0.05).Experimental group:operation time(115.92±12.23)min,intraoperative blood loss(129.25±16.15)mL,postoperative drainage volume(82.44±25.57)mL,fracture healing time(17.89±2.39)w;Control group:operation time(172.75±15.09)min,intraoperative blood loss(177.24±14.36)mL,postoperative drainage volume(115.06±21.95)mL,fracture healing time(19.93±3.75)w.The operative time and fracture healing time of the experimental group were less than those of the control group(P<0.05),and the intraoperative blood loss and postoperative drainage volume of the experimental group were less than those of the control group,the difference was statistically significant(P<0.05).The Buewell-Charnley fracture reduction radio-logical evaluation criteria were used to evaluate the fracture reduction,and the rate of good reduction was 96.29%in the experimental group and 93.10%in the control group.There was no statistical significance in the anatomical reduction between the two groups(P>0.05).Visual analog scale(VAS)was used to evaluate postoperative pain,and pain VAS scores of the experimental group were lower than those of the control group at 3 days,1 week and 4 weeks after surgery(P<0.05).Both groups were followed up for at least 12 months after surgery,and the incidence of postoperative complications in the experimental group was lower than that in the control group(P<0.05).The AOFAS score of the experimental group was higher than that of the control group at 3 months,6 months and 12 months after surgery(P<0.05).Conclusion Improvement on the medial approach retains the superior extensor retinaculum,relative to the combined surgical approach to cut off the superior extensor retinacu-lum treatment Rüedi-Allg?wer Ⅲ Pilon fractures,with shorter operation time,less intraoperative blood loss,less postoperative complications and other advantages.The functional recovery of the ankle joint in the modified antero-medial approach preserving the superior extensor retinaculum was better than that in the combined approach cutting the superior extensor retinaculum.

Objective To explore the clinical efficacy of modified anteromedia approach with superior extensor retinaculars and traditional anteromedia combined with posterolateral approach in the treatment of Rüedi-Allg?wer type Ⅲ Pilon fractures.Methods In this study selected 56 patients with Rüedi-Allg?wer type Ⅲ Pilon fractures treated in our hospital from January 2020 to January 2022,all of whom met the inclusion and exclusion criteria,27 in the experimental group and 29 in the control group.Both groups underwent open reduction and internal fixation of Pilon fractures.The experimental group used a modified anteromedial approach to preserve the supraspinatus,while the control group used a traditional anteromedial combined with posterolateral approach to cut off the supraspinatus.The general clinical data,operation time,intraoperative blood loss,postoperative drainage volume,fracture reduction quality,early pain VAS score,complications and ankle function evaluation of the experimental group and the control group were compared in detail,and the early clinical efficacy of the two surgical methods was analyzed and compared.Results There were no significant differences in age,gender,body mass index(BMI),complications,injury mechanism and the time from admission to operation between the experimental group and the control group(P>0.05).Experimental group:operation time(115.92±12.23)min,intraoperative blood loss(129.25±16.15)mL,postoperative drainage volume(82.44±25.57)mL,fracture healing time(17.89±2.39)w;Control group:operation time(172.75±15.09)min,intraoperative blood loss(177.24±14.36)mL,postoperative drainage volume(115.06±21.95)mL,fracture healing time(19.93±3.75)w.The operative time and fracture healing time of the experimental group were less than those of the control group(P<0.05),and the intraoperative blood loss and postoperative drainage volume of the experimental group were less than those of the control group,the difference was statistically significant(P<0.05).The Buewell-Charnley fracture reduction radio-logical evaluation criteria were used to evaluate the fracture reduction,and the rate of good reduction was 96.29%in the experimental group and 93.10%in the control group.There was no statistical significance in the anatomical reduction between the two groups(P>0.05).Visual analog scale(VAS)was used to evaluate postoperative pain,and pain VAS scores of the experimental group were lower than those of the control group at 3 days,1 week and 4 weeks after surgery(P<0.05).Both groups were followed up for at least 12 months after surgery,and the incidence of postoperative complications in the experimental group was lower than that in the control group(P<0.05).The AOFAS score of the experimental group was higher than that of the control group at 3 months,6 months and 12 months after surgery(P<0.05).Conclusion Improvement on the medial approach retains the superior extensor retinaculum,relative to the combined surgical approach to cut off the superior extensor retinacu-lum treatment Rüedi-Allg?wer Ⅲ Pilon fractures,with shorter operation time,less intraoperative blood loss,less postoperative complications and other advantages.The functional recovery of the ankle joint in the modified antero-medial approach preserving the superior extensor retinaculum was better than that in the combined approach cutting the superior extensor retinaculum.

BACKGROUND:The importance of autophagy for maintaining cellular homeostasis and stress response has long been recognized.As a way for cells to selectively clear their damaged organelles to achieve the recycling of cellular components,autophagy has a pivotal role in bone metabolism.OBJECTIVE:To review the role and possible mechanisms of autophagy in regulating bone-related cell activity and function among bone marrow mesenchymal stem cells,osteoblasts,osteocytes,and osteoclasts.METHODS:PubMed was searched for studies related to autophagy using the keywords of "autophagy;bone marrow mesenchymal stem cells;osteoblasts;osteocytes;osteoclasts."RESULTS AND CONCLUSION:We finally included 84 papers.Autophagy plays an important role in bone metabolism.Autophagy is involved in maintaining the balance between mineralization and absorption,and then maintaining bone homeostasis.An appropriate autophagy inducer may also benefit bone remodeling.Abnormal autophagy can lead to disorders of bone balance,leading to diseases such as osteoporosis.We may prevent or treat bone-related diseases by regulating the level of autophagy as its function in maintaining the balance of mineralization and resorption in bone homeostasis.

Objective To investigate the changes of antimicrobial peptide LL-37 and C-reactive protein (CRP ) in the patients with Pseudomonas aeruginosa positive sputum culture and their mutual relation . Methods Fifty cases of Pseudomonas aeruginosa positive sputum culture and 27 cases undergoing physical ex-amination in the Guangdong Provincial Hospital of Chinese Medicine from September 2016 to May 2017 were selected as the research subjects .The level of antimicrobial peptide LL-37 was detected by double antibody sandwich ELISA and the CRP level was detected by immunoturbidimetry .Results The levels of antimicrobial peptide LL-37 and CRP in the Pseudomonas aeruginosa positive sputum culture group were significantly high-er than those in the healthy control group ,the difference was statistically significant (P< 0 .05) ,and they showed the positive correlation (r=0 .411 ,P<0 .05) .Conclusion In positive sputum culture of Pseudomonas aeruginosa ,antimicrobial peptide LL-37 and CRP levels are increased ,which has a certain clinical application value for the early diagnosis of infection .

Objective To investigate whether miR-122 is a target of oxymatrine against HBV. Methods HepG2.2.15 cells were incubated with culture medium containing different concentrations of oxymatrine. The cyto-toxicity of oxymatrine was determined by cck-8 assay. The surface antigen of HBV (HBsAg),antigenof HBV (HBeAg)and HBV DNA in supernatant and intracellular miR-122 were determined in HepG2.2.15 cells after incu-bation with culture medium containing oxymatrine for 72 h. Results The survival percentage of HepG2.2.15 cells under different concentrations of oxymatrine was higher than 95% when the concentration of oxymatrine was lower than 4 mg/mL. After treatment with oxymatrine for 72 h,the secretion of HBsAg and HBeAg,the level of HBV DNA in the supernatant were reduced. The intracellular miR-122 in oxymatrine experience group was 3.5 times higher than that in the negative control group. Conclusions Oxymatrine might be used to inhibit viral replication and antigen expression by enhancing the expression of miR-122 in HepG2.2.15 cells.

Staphylococcus aureus is a major cause of hospital-acquired infection. Because the bacteria are very easy to become resistant to antibiotics, vaccination is a main method against S. aureus infection. Clumping factor B (ClfB) is an adhesion molecule essential for S. aureus to colonize in the host mucosa and is regarded as an important target antigen. In this study, we successfully used Escherichia coli to express a segment encoding the N1-N3 regions of ClfB protein (Truncated-ClfB) cloned from S. aureus. The protein was purified by affinity and ion exchange chromatographies and gel filtration. Rabbits were immunized three times with purified Truncated-ClfB. After that, blood was collected to prepare serum which were then used for measurement of antibody level. Phagocytosis of S. aureus opsonized by the serum was determined by a flow cytometry. Results show that the serum IgG titer reached 1:640 000. Phagocytosed S. aureus by polymorphonuclear leukocytes were significantly more when the bacteria were opsonized by the serum from Truncated-ClfB immunized rabbits than those from no immunized group (P < 0.01). Therefore, the results indicated that Truncated-ClfB could be a promising vaccine candidate against S. aureus infection.
Adhesins, Bacterial ; immunology ; Animals ; Antibodies, Bacterial ; blood ; Escherichia coli ; Flow Cytometry ; Immune Sera ; Immunoglobulin G ; blood ; Opsonin Proteins ; immunology ; Phagocytosis ; Rabbits ; Staphylococcal Infections ; immunology ; Staphylococcus aureus

Objective To analyze the CT and MRI appearances and to improve the knowledge of peripheral primitive neuroectodermal tumors(pPNETs).Methods CT or MRI were performed in 19 patients of pPNETs,which were confirmed by pathology.Results All the tumors were with unclear margin.Three cases occurred in intracalvarium,7 in the extremities,2 in the chest,4 in the abdomen,and 3 inside the spine.CT appearance of the tumors arising from soft tissue showed large,ill-defined,non-calcified mass and heterogeneous appearance with hypodense cystic areas.The tumors demonstrated heterogeneous contrast enhancement.The pPNETs arising from bone demonstrated extensive lytic lesion with large soft tissue mass,one case with newly-born bone and demonstrated heterogeneous contrast enhancement.The tumors demonstrated homogeneous intensity as muscle on SE T1WI and heterogeneous hyperintense signal on T2WI.Immunohistochemically,tumor cells showed positive for CD99,Syn,GFAP and negative for LCA.Conclusion The pPNETs show no characteristic manifestations on CT and MRI.However,CT and MRI can show the intra-tumor structures and the extent of the tumor very well,which is helpful in differentiating diagnosis,predicting resectability,detecting distant metastases and evaluating the response to treatment.