OBJECTIVE: To compare the effectiveness of Achillon Achilles tendon suture guide combined with circuit suture under the perineural channel and Krachow suture with posterolateral incision of Achilles tendon in the treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture. METHODS: The clinical data of 38 patients with Kuwada type Ⅱ acute closed Achilles tendon rupture who met the selection criteria between January 2020 and December 2023 were retrospectively analyzed. Krachow suture via posterolateral incision was used in 24 cases (traditional group), and Achillon Achilles tendon suture guide combined with circuit suture via perineural channel was used in 14 cases (minimally invasive group). There was no significant difference in baseline data such as age, gender, body mass index, cause of injury, time from injury to operation, characteristics of Achilles tendon injury (broken end distance, stump length), and preoperative Achilles tendon total rupture score (ATRS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot function score between the two groups ( P>0.05). The operation time, incision length, hospital stay, and complications (re-tear, incision infection, sural nerve irritation, deep venous thrombosis) were recorded. ATRS score and AOFAS ankle and hindfoot function score were used to evaluate the effectiveness before operation and at 3 and 6 months after operation. RESULTS: All patients successfully completed the operation. The operation time, incision length, and hospital stay in the minimally invasive group were significantly shorter than those in the traditional group ( P<0.05). Patients in both groups were followed up 8-16 months, with an average of 12.7 months. There was no sural nerve injury or re-tear of Achilles tendon in both groups. In the traditional group, 1 case had incision infection,1 case had suture rejection, and 1 case had intermuscular venous thrombosis; in the minimally invasive group, no incision healing complication, suture knot discomfort, or thrombosis occurred. There was no significant difference in the incidence of complications between the two groups ( P=0.283). The ATRS score and AOFAS ankle and hindfoot function score of the two groups were improved after operation, but there was no significant difference ( P>0.05). Except that there was no significant difference in AOFAS ankle and hindfoot function scores between the two groups at 6 months after operation ( P>0.05), the ATRS scores and AOFAS ankle and hindfoot function scores in the minimally invasive group were significantly better than those in the traditional group at other time points ( P<0.05). CONCLUSION The treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture with Achillon Achilles tendon suture guide combined with circuit suture via the perineural channel has similar ankle function comparable to traditional operation, but the incision is smaller and the incidenc of incision infection is lower, which is beneficial for patients to recover early ankle function.
Humans ; Achilles Tendon/injuries* ; Suture Techniques ; Retrospective Studies ; Tendon Injuries/surgery* ; Rupture/surgery* ; Sutures ; Male ; Treatment Outcome ; Female ; Minimally Invasive Surgical Procedures/methods* ; Adult

Objective:To evaluate the clinical efficacy of A-PRF in the preservation of alveolar ridge after tooth extraction.Methods:Electronic databases of VIP,CNKI,Wanfang,CQVIP,Medline,Pubmed and Cochrane library were searched.The meta-analysis was performed by using Revman 5.4.Results:5 RCTs including 217 patients were identified.A-PRF can significantly reduce the vertical bone absorption of the extraction socket,can increase the amount of new bone formation in the extraction socket(P＜0.05).However,A-PRF can not effectively reduce the horizontal bone absorption and can not improve the bone density in the extraction socket(P＞0.05).Conclusion:A-PRF is effective in the alveolar ridge preservation after tooth extraction.

Bone marrow mesenchymal stem cells （BMSCs） are derived from stem cells isolated from bone marrow and have the potential for multidirectional differentiation and self-renewal. Under certain conditions， BMSCs can be induced to differentiate into osteoblast （OB）， chondrocyte， adipocyte， fibroblast， etc. BMSCs play an important role in maintaining the stability of bone structure and balancing bone metabolism. Promoting the proliferation of BMSCs and inducing their differentiation into OB of great significance for the clinical prevention and treatment of osteoporosis， bone defects， fracture healing， and other diseases. Because the proliferation and osteogenic differentiation of BMSCs are complex processes controlled by multiple genes and regulated by multiple signal transduction pathways， traditional Chinese medicine （TCM） happens to have the advantages of multi-bioactive component， multi-target， and multi-pathway synergism， which can affect the proliferation and differentiation of BMSCs through multiple channels and induce the proliferation of BMSCs. The transcription and expression of genes related to osteogenesis can be enhanced to promote the differentiation of BMSCs into OB， so as to achieve the purpose of preventing and treating osteoporosis， bone defects， and other bone diseases. Based on the literature on the intervention of TCM monomers and compounds in the proliferation and osteogenic differentiation of BMSCs， this study reviewed TCM monomers and compounds in promoting the proliferation and osteogenic differentiation of BMSCs by regulating secreted glycoprotein （Wnt）， neurogenic locus notch homolog protein （Notch）， mitogen-activated protein kinase （MAPK）， phosphatidylinositol-3 kinase （PI3K） /protein kinase B （Akt）， bone morphogenetic protein （BMP）/Smad， Janus kinase （JAK）/signal transducer and activator of transcription protein （STAT）， osteoprotegerin （OPG）/receptor activator of nuclear factor-kappa B （RANK）/RANK ligand （RANKL）， and other signaling pathways to provide new ideas for the research and clinical application of Chinese medicine in the prevention and treatment of orthopedic diseases.

Objective To explore the risk factom of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.Methods One hundred and fifty-eight cases hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis were selected.According to whether complicated with liver failure,the patients were divided into observation group with 62 cases (complicated with liver failure group) and control group with 96 cases (without liver failure group).The clinical data and results of 2 groups were analyzed to screen the risk factors of liver failure.Results Compared with control group,observation group in alanine aminotransferase,aspartate aminotransferase,cholinesterase,total bilirubin,and prothrombin time,activated partial thrombin time live enzymes,thrombin time,fibrinogen,serum creatinine,the differences were not statistically significant (P ＞ 0.05);in albumin ((28.02±7.36) g/L vs.(23.26±6.54) g/L,t =4.421,P =0.002),serum urea nitrogen ((8.84±4.71) mmol/L vs.(9.33±5.24) mmol/L,t =3.656,P=0.007),upper gastrointestinal bleeding(x2 =7.534,P=0.006),ascites (x2 =8.615,P =0.003),infection (x2 =10.321,P =0.001),hepatic encephalopathy (x2 =6.561,P =0.010),hepatorenal syndrome(x2 =4.952,P=0.026),the difference were statistically significant.(2)The results of logistic regression analysis showed that upper gastrointestinal bleeding (OR =1.020,95％ CI:1.003-1.036),hepatorenal syndrome(OR=2.872,95％CI:0.385-21.423) were risk factor of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.Conclusion Upper gastrointestinal bleeding,hepatorenal syndrome are independent risk factors of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.

Objective:To evaluate the effect of epigallocatechin-3-gallate (EGCG) and epigallocatechin-3-O-(3-O-methyl)-gallate (EGCG-3Me) on the anti-bacterial effect and the stability of intraradicular dentin-adhesive interface.Methods:EGCG and EGCG3Me with the concentration of 400 μg/ml were incorporated into Single Bond 2 (SB2) respectively to obtain 2 modified adhesives E-SB2 and E3-SB2.Confocal laser scanning microscopy(CLSM) and ultraviolet spectrophotometry were used to evaluate the anti-bacterial effect of the modified adhesives.Micro-Raman spectrum was used to test the degree of conversion (DC) of the adhesives.Push-out bond strength test was conducted to examine the immediate bond strength and the bond strength after themocycling.Results:E-SB2 and E3-SB2 both showed inhibiting effect on the proliferation of E.faecalis,while E3-SB2 performed stronger inhibiting effect.DC and the immediate push-out bond strength of SB2 were not decreased with the incorporation of EGCG or EGCG-3Me(P ＞ 0.05).E-SB2 and E3-SB2 showed significantly higher push-out bond strengths than that of SB2 (P ＜ 0.05) after themocycling.Conclusion:EGCG and EGCG-3Me modified adhesives have anti-bacterial effect and can enhance the stability of bonding between intraradicular dentin and adhesive,EGCG-3Me may have stronger anti-bacterial effect.

Objective:To evaluate the clinical outcomes of implant-retained overdentures.Methods:57 patients treated by implant-retained overdentures were included.Parameters for peri-implant tissue conditions (e.g.peri-implant probing depth,plaque index,bleeding on probing,mucosal hyperplasia,peri-implant marginal bone loss) and prosthetic complications were examined and recorded.The precentage of satisfaction of the patients was assessed using the visual analog scale (VAS).Results:After an average follow-up of (48±11.3) months,the survival rate of the implants was 98.1%,the marginal bone loss was (1.38±0.74) mm.There was no statistically difference among the different attachment groups(bar,magnet and ball) regarding the peri-implant marginal bone loss or bleeding on probing(P>0.05).The peri-implant probing depth and plaque index in patients with magnet and ball attachments were lower than those in patients with bar attachments(P<0.05).The major complications were the upper abutment fracture,prostheses fracture and screw loosening.Most patients were satisfied with their prostheses and there was no statistically significant difference between the attachment types(P>0.05),except that magnet and ball attachments were much easier to clean compared with bar attachments(P<0.05).Conclusion:Implant-retained overdenture is a successful and satisfactory treatment option for patients with edentulous jaw.The patients should been given regular clinical examinations to keep peri-implant tissue health and reduce the complications,especially those with bar attachments.

Objective To explore the influence factors of cirrhosis complicated with upper gastrointestinal bleeding,and to guide the clinical treatment of patients with cirrhosis and prevent upper gastrointestinal bleeding.Methods One hundred and seventy-five cases patients with cirrhosis and upper gastrointestinal bleeding were treated in the Infectious Disease Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2015 as the case group.One hundred and eighty-two patients with cirrhosis and no upper gastrointestinal bleeding at the same period in hospital as the control group.A face to face questionnaire was used to fill in the questionnaire.Results Multifactor conditional Logistic regression analysis showed that onset season (OR =4.185,95％ CI:1.874-8.354),non steroidal drugs (OR =6.215,95％ CI:2.681-15.532),drinking (OR =5.481,95％ CI:3.205-11.225),portal vein highpressure gastropathy(OR =7.658,95％ CI:3.227-14.714),diameter of portal vein (OR =8.901,95％ CI:1.218-9.026),liver function classification (OR =13.124,95 ％ CI:2.107-15.228) and esophageal varices (OR =11.021,95％ CI:2.181-13.487) were related with patients with liver cirrhosis complicated with upper digestive tract hemorrhage.Conclusion The onset season,nonsteroidal anti-inflammatory drugs,drinking,portal hypertensive gastropathy,portal vein diameter,liver function classification and esophageal varices are the risk fators of liver cirrhosis complicated with upper digestive tract hemorrhage factors.