BACKGROUND:Lisfranc ligament is an important structure to maintain the transverse and longitudinal arch of the foot.This injury is a serious middle-foot injury.Lisfranc ligamentous injuries are complex,and their treatment,along with the preferred method of fixation,is controversial. OBJECTIVE:To compare the short-term efficacy of plate combined with Suture tape versus plate combined with headless compression screw in the treatment of Lisfranc injury with comminuted fractures of the 1st and 2nd proximal metatarsal bones. METHODS:A retrospective analysis was performed on 48 patients with Lisfranc injury due to comminuted fractures of the 1st and 2nd proximal metatarsal bones in Seventh Department of Orthopedics,Dongguan Hospital of Traditional Chinese Medicine from January 2019 to June 2022.Among them,25 were fixed with plate combined with Suture tape(observation group)and 23 were fixed with plate combined with headless compression screw(control group).Preoperative classification was performed according to Myerson classification system based on preoperative imaging data.Postoperative follow-up was performed according to fracture healing time,visual analog scale,and American Orthopaedic Foot and Ankle Society(AOFAS)criteria to assess the recovery of foot functions.Postoperative complications were compared and analyzed between the two groups. RESULTS AND CONCLUSION:(1)All cases completed the operation successfully and obtained follow-up in the two groups.The postoperative follow-up time of the two groups was 12-36 months,with a mean of(18.0±5.42)months.(2)There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).(3)The fracture healing time of observation group was slightly longer than that of control group(P<0.05).(4)After 3,6,and 12 months of follow-up,the visual analog scale score of the observation group was significantly lower than that of the control group(P<0.05).(5)At 6 and 12 months after operation,AOFAS score of foot function in the observation group was significantly improved compared with the screw group at various time points after operation(P<0.05),and was significantly higher than that before operation(P<0.05).(6)The postoperative complications were 1 case of traumatic arthritis in the observation group and 1 case of incision infection,1 case of screw fracture,and 2 cases of traumatic arthritis in the control group.There was no significant difference between the two groups(P>0.05),considering the correlation with a small sample size.(7)It is indicated that as for the surgical method of Lisfranc injury with comminuted fractures of the 1st and 2nd proximal metatarsal bones,the application of plate combined with Suture tape internal fixation has a reliable effect in the treatment of Lisfranc joint injury,which can improve the function of the foot joint of patients,and has the advantages of less surgical trauma,fewer postoperative complications,and lower risk of long-term iatrogenic traumatic arthritis.Compared with headless compression screw,it is more beneficial to the recovery of foot function.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

A novel coronavirus pneumonia (NCP) epidemic has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the NCP patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the NCP patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of NCP, providing a basis for the clinical treatment of such kind of patients.

Objective To analyze the risk factors of cerebral microbleeds (CMBs) in acute cerebral infarction patients. Methods We consecutively included 255 acute cerebral infarction patients who were admitted in Neurology Department of the First Affiliated Hospital of Fujian Medical University from January 2014 to December 2016. According to the number and location of CMBs, the patients were divided into infratentorial, cortical and deep cerebral groups, each of which included non-mild and moderate-severe subgroups. The differences of the level of glomerular filtration rate (eGFR) and some common arteriosclerotic risk factors were analyzed between subgroups, and the multiple logistic regression analysis was performed. Results A total of 140 subjects (54.9%) had CMBs. In the infratentorial group, the proportion of patients who were with low eGFR level in the moderate-severe CMBs subgroup was higher than in the non-mild CMBs subgroup (P=0.024). The low eGFR level (OR=3.874, 95% CI:1.261～11.901, P=0.018) and the long duration of hypertension (OR=2.128, 95%CI: 1.004～4.510, P=0.018) were the independent risk factors of the moderate-severe infratentorial CMBs. Conclusion The low eGFR level and long duration of hypertension are risk factors for the moderate and severe infratentorial CMBs after acute ischemic stroke.

Excessive or persistent inflammatory response is an important pathophysiological feature of sepsis, and the tissue damage and organ dysfunction caused by sepsis are related to the prognosis of patients. The cholinergic anti-inflammatory pathway releases acetylcholine (ACh) through the vaginal nerve and acts on the surface of the inflammatory cell α7 nicotine acetylcholine receptor (α7nAChR) to inhibit the production of inflammatory factors, so that the inflammatory response tends to be balanced. This article reviews the composition and effects of cholinergic anti-inflammatory pathways, the mechanism of regulating sepsis and its clinical application, in order to provide a new direction for the treatment of sepsis.

Objective To investigate the effectiveness of intratympanic dexamethasone injection as a protec-tion agent against cisplatin ototoxicity.Methods Fifty five healthy guinea pigs were randomly divided into four groups.The guinea pigs groups received (group I)0.9% NaCl solution(16 ml/kg)intraperitoneally (IP),(group II)dexamethasone (10 mg/ml)intratympanically(IT),(group III)cisplatin (16 mg/kg)only intraperitoneally(IP) and (group IV)dexamethasone (10 mg/ml)IT followed after 1h by 16 mg/kg cisplatin.Before and 7 days following injections,the ototoxic effect was measured with auditory brainstem response(ABR).The contents of malondiade-hyde(MDA)and activities of superoxide dismutase(SOD)were also measured.Results ABR thresholds before and after dosing were 28.50±4.74,29.00±3.94 dB nHL and 28.67±5.82,31.33±5.81 dB nHL in group I and group II,respectively,with no significant differences (P>0.05).The contents of MDA and activities of SOD were 2.01 ±0.07 mmol/L ,234.10±13.09 U/ml and 2.06±0.09 mmol/L,233.20±13.24 U/ml in the group I and group II, respectively,with no significant differences (P>0.05).ABR thresholds after dosing were 55.33±4.81,and 40.67 ±3.72 dB nHL in the group III and group IV,which were significantly increased,but ABR thresholds in the group IV were significantly lower than that in the group III (P<0.05).The contents of MDA were 5.74±0.17,3.51± 0.18 mmol/L in the group III and group IV,which were significantly increased.SOD activities were 107.90 ± 14.21,and 162.70±11.25 U/ml,which significantly decreased.Nevertheless,in the group IV dexamethasone rela-tively reduced the contents of MDA(P<0.001)while increased the activities of SOD(P<0.001)compared with group III.Conclusion Intratympanic dexamethasone injection presents as an effective treatment modality to prevent cisplatin ototoxicity without any ototoxic effect.

OBJECTIVE: To investigate the effectiveness of cisplatin on the expressions of Bcl-2 and Bax in cochlea and spiral ganglion cells (SGC) of guinea pigs. METHOD: Twenty guinea pigs were randomly divided into cisplatin (n = 10) and control groups (n = 10). Cisplatin group were administrated with a dose of intraperitoneal injection of 16 mg/kg, while the control group were received intraperitoneal injection of normal saline as placebo. Before and 7 days following injections, the ototoxic effect was measured with distortion product otoacoustic emission (DPOAE). Bcl-2, Bax in cochlea were detected by Western Blot. Immunohistochemical staining was used to detect the protein levels of Bcl-2 and Bax in spiral ganglion cells. RESULT: In control and cisplatin group, Bcl-2 protein levels were 0.727 8 ± 0.016 9 and 0.467 6 ± 0.020 1, Bax protein levels were 0.384 8 ± 0. 0217 and 0.735 6 ± 0.022 3 in cochlea respectively, both P < 0.01. In Control and cisplatin group, the grey values of Bcl-2 in SGC were 99.00 ± 2.42 and 149.80 ± 2.37 respectively, the grey values of Bax were 154.50 ± 2.80 and 104.50 ± 3.09 respectively, both P < 0.05. CONCLUSION Decreased expression of Bcl-2 and increased expression of Bax may be involved in cisplatin-induced apoptosis in cochlea and SGC of guinea pigs.
Animals ; Apoptosis ; Cisplatin ; pharmacology ; Cochlea ; metabolism ; Guinea Pigs ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Spiral Ganglion ; drug effects ; metabolism ; bcl-2-Associated X Protein ; metabolism

Objective To investigate the infection status quo of 21 kinds of genotypes of human papillomavirus (HPV)and their distribution rule among the women in Hengyang region.Methods A total of 8 032 women voluntarily accepting cervical cancer screening in the Hengyang Municipal Maternal and Child Health Care Hospital fromg April 2012 to May 2013 were selected as the research subjects.The exfoliated cells samples of cervical tissue were collected for detecting 21 kinds of HPV genotypes by Hybri-Max.The HPV infectious rate and the HPV gene distribution were analyzed by using SSPS13.0.Results Of 8 032 women,1 664 cases were detected out 1 kind or more than 2 kinds of HPV,the HPV infectious rate was 20.72%(1 664/8 032).The top 6 geno-types of HPV were HPV16,52,58,81,53 and 18.Among 1 664 female cases of HPV infection,the single HPV infection rate was 76.44%,the multiple infection rate was 23.56%,which was dominated by the double infection;the total positive rate in the various age groups of HPV infection presented theU-type distribution with the age increase,however the total positive rate had no statis-tically significant differences among all age groups(P >0.05 ).Conclusion The HPV female infection rate in Hengyang region is relatively higher,moreover the high risk HPV is predominant.HPV 16 occupies the top ranking.

OBJECTIVE: To evaluate effectiveness of endoscopic tragus cartilage-perichondrium in the treatment of large tympanic membrane perforations. METHOD: Patients with large tympanic membrane perfortations who had underwent cartilage-perichondrium myringoplasty were retrospectively retrieved from our department. Those with a follow-up of equal to or greater than 12 months after surgery were included in the study. Hearing test results were reported using a four-frequency air conduction and bone-air conduction gap. Patients were labeled as treatment success if the tympanic membrane was intact without lateralization or anterior blunting after surgery. RESULT: Of the 35 patients with large tympanic membrane perforations treated by endoscopic tragus cartilage-perichondrium, 33 (94.3%) were treatment success. There was no graft lateralization, anterior blunting, neocholesteatoma, and sensorineural hearing loss in these patients after surgery. The air conduction and bone-air conduction gap before surgery in the study cohort were (43.8 ± 5.7) dB and (28.5 ± 3.1) dB, respectively. Postoperative air conduction and bone-air conduction gap of the cohort were (31.4 ± 6.4) dB HL and (16.2 ± 4.1) dB, respectively. The postoperative air conduction and bone-air conduction gap decreased significantly after surgery (P < 0.01). Overall postoperative air-bone gap in 27 of the 35 patients (77%) were less than 20 dB after surgery. CONCLUSION Endoscopic cartilage-perichondrium myringoplasty is an effective procedure in the treatment of large tympanic membrane perforations.
Bone Conduction ; Cartilage ; Cohort Studies ; Ear Auricle ; Endoscopy ; Hearing ; Hearing Tests ; Humans ; Myringoplasty ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; Tympanic Membrane Perforation ; surgery ; Tympanoplasty

OBJECTIVE: To explore the influence of sublingual immunotherapy on Th2 type immunoreaction in patients with allergic rhinitis within 12 months' treatment. METHOD: Forty three patients with allergic rhinitis were followed-up within 12 months after receiving sublingual immunotherapy. The changes of clinic symptoms and immunoreaction were analyzed. VAS score was applied to evaluate the efficacy of clinic treatment. TIgE and sIgE in serum were tested to evaluate the systemic immunoreaction. Eosinophil counting in nasal discharge was applied to evaluate the local nasal mucosa immunoreaction. RESULT: VAS scores were decreased significantly one month after the starting point of treatment, companied by the decrease of EOS count in nasal discharge (P < 0.05). The changes of TIgE and sIgE in serum within 12 months of sublingual immunotherapy were not significant (P < 0.05). The levels of IL-4 and IL-13 in nasal lavage were decreased significantly after 12 months' treatment. CONCLUSION The bias of Th2 type immunoreaction existed in nasal mucosa immune system in patients with allergic rhinitis could been rectified partially after receiving sublingual immunotherapy for 12 months, but the significant changes were not observed in systemic immune system.
Adolescent ; Adult ; Animals ; Child ; Eosinophils ; immunology ; Female ; Humans ; Immunoglobulin E ; blood ; Interleukin-13 ; immunology ; Interleukin-4 ; immunology ; Male ; Middle Aged ; Mites ; immunology ; Rhinitis, Allergic ; immunology ; therapy ; Sublingual Immunotherapy ; Th2 Cells ; immunology ; Young Adult