Synovial Fluid α-MSH Levels are Inversely Correlated with Articular Cartilage Degeneration in Anterior Cruciate Ligament Deficient Knees.

BACKGROUND: Secondary osteoarthritis after ligament or meniscus injury generally causes great burdens to patients. Alpha-melanocyte-stimulating hormone (α-MSH ), a 13 amino acid neuropeptide produced by intracellular cleavage of the proopiomelanocortin (POMC) hormone, has been proven to suppress inflammation and protect cartilage from damage. The present study was carried out to explore the relationship between synovial fluid α-MSH levels and articular cartilage degeneration in patients with anterior cruciate ligament (ACL) deficiency. METHODS: 51 patients with ACL deficiency admitted to our hospital were enrolled. The Noyes score method was used to assess articular cartilage damage arthroscopically. Synovial fluid α-MSH levels were examined using a double antibody radioimmunoassay method. Inflammation markers such as IL-6, MMP-3, and degradation biomarker of collagen type II (CTX-II) were also explored by enzyme-linked immunosorbent assay (ELISA). RESULTS: The articular cartilage in ACL deficiency patients deteriorated significantly with time after injury (r = 0.673, p < 0.001). Synovial fluid α-MSH levels are inversely associated with Noyes scores (r = -0.682, p < 0.001), levels of inflammation markers IL-6 (r = -0.302, p = 0.035), MMP-3 (r = -0.652, p < 0.001) and degradation biomarker CTX-II (r = -0.584, p < 0.001). CONCLUSIONS: Synovial fluid α-MSH levels showed an independent and negative correlation with articular cartilage degeneration in patients with knee ACL deficiency. Supplementing with a-MSH may serve as a possible adjuvant therapy for delaying cartilage degeneration after ACL injury.

Reconstructing a complex central facial defect with a multiple-folding radial forearm flap.

The central face is the dominant feature of humans. A complex central facial defect can severely affect a person's appearance and function and can pose significant challenges for reconstructive surgeons. The aims and principles of central facial reconstruction are to achieve adequate function and esthetics. This report describes the case of a 45-year-old man who was bitten in the central face by a wild boar. A free radial forearm flap was designed as a multiple-folding flap that was divided into several portions. The folded portions of the flap were used to reconstruct the nasal mucosa, oral mucosa, and upper lip defects and provided the lining for an eventual staged nasal reconstruction. The patient achieved good functional recovery and had a good esthetic outcome.

[The transplantation of latissimus dorsi flap of the base of T shape artery with the pedicle of the thoracodorsal artery].

OBJECTIVE: To explore the possibility that the free latissimus dorsi musculo-cutaneous flap to repair the forearm leg wound. METHODS: To design latissimus dorsi musculo-cutaneous flap which is foundation on T form thoracodorsal artery stalk. To set the short arm into the receiver artery break and anastomos them. It is not only reassure the blood of free musculo-cutaneous flap, but also reconstruct the continuation of the receiver main artery. RESULTS: In 16 patients, 15 patients success completely, 1 patient main success. The blood supply of receiver is adequate. CONCLUSIONS: The free T form thoracodorsal artery stalk musculo-cutaneous flap free grafting is a good method to repair the skin and soft tissues defection of forearm and leg.