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Atomically ordered intermetallic compounds (IMCs) have been extensively studied for exploring catalysts with high activity, selectivity, and longevity. Compared to random alloys, IMCs present a more pronounced geometric and electronic effect with desirable catalytic performance. Their well-defined structure makes IMCs ideal model catalysts for studying the catalytic mechanism. This review focuses especially on elemental composition, electron transfer, and structure/phase evolution under high temperature treatment conditions, providing direct evidence for the migration and rearrangement of metal atoms through electron microscopy. We then present the outstanding applications of IMCs in growing single-walled nanotubes, hydrogenation/dehydrogenation reactions, and electrocatalysis from the perspective of electronic, geometric, strain, and bifunctional effects of ordered IMCs. Finally, the current obstacles associated with the use of in situ techniques are proposed, as well as future research possibilities.
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Human epidermal growth factor receptor 2-tyrosine kinase inhibitors (HER2-TKIs) have been extensively utilized for treating HER2-positive metastatic breast cancer (MBC), with numerous clinical trial reports available. We aim to systematically perform a comprehensive clinical evaluation on HER2-TKIs, provide a reference for the clinical rational use of drugs, and serve for the decision-making of the national drug policy. We performed comprehensive clinical evaluation in six dimensions including safety, effectiveness, economy, suitability, accessibility, and innovation through meta-analysis, literature review, drug administration websites, and other relevant medication data to analyze HER2-TKIs in treating HER2-positive MBC. For safety, the risk of ≥ grade 3 adverse events among pyrotinib, lapatinib, and neratinib is not significantly different. Furthermore, pyrotinib and neratinib were found to be higher in the risk of ≥ grade 3 diarrhea than lapatinib, however the risk could be reversed and prevented with loperamide. Regarding effectiveness and economy, pyrotinib was confirmed to have the best efficacy and cost-utility value, neratinib the second, and lapatinib the third. As regards innovation and suitability, pyrotinib showed better than other HER2-TKIs. In addition, pyrotinib received a higher recommendation than other HER2-TKIs in patients with HER2-positive MBC. The accessibility of pyrotinib was found to be the best with better urban, rural, and national affordability and lower annual treatment costs. Pyrotinib is more valuable in clinics with better safety, effectiveness, economy, suitability, accessibility, and innovation in HER2-positive MBC. This study could provide references for the clinical application of HER2-TKIs in treating HER2-positive MBC.
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Neoplasias da Mama , Inibidores de Proteínas Quinases , Receptor ErbB-2 , Humanos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Receptor ErbB-2/metabolismo , Feminino , Inibidores de Proteínas Quinases/uso terapêutico , Lapatinib/uso terapêutico , Antineoplásicos/uso terapêutico , Quinolinas/uso terapêutico , Quinolinas/efeitos adversos , Acrilamidas , AminoquinolinasRESUMO
We report a sodium-ion battery anode design using red phosphorus encapsulated in nitrogen-doped porous carbon nanofibers that mitigates volume expansion and poor conductivity issues, enhancing battery performance. Density functional theory calculations suggest nitrogen doping promotes robust phosphorus interactions, and finite element analysis indicates the design controls volume expansion.
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Fabricating optimum surface structures represents an attractive approach for synthesizing supported catalysts with high activity and specific selectivity. New active sites could be flexibly constructed via the strong metal-support interaction under the redox condition. Herein, we demonstrated the formation of a new Rh-Si surface on a silica-modified carbon nanotube supported Rh catalyst under the high-temperature reduction condition as well as a thin amorphous silica coating layer and weak chemisorption toward the CO molecule. The electronic interactions between Rh and Si, along with the particular structure, guarantee desirable catalytic performance for the semihydrogenation of phenylacetylene under mild conditions. This facile approach might be extensively used in constructing new active sites with robust activity and specific selectivity in diverse heterogeneous catalysis systems.
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In the absence of adequate treatment, effective bone regeneration remains a great challenge. Exploring hydrogels with properties of excellent bioactivity, stability, non-immunogenicity, and commercialization is an important step to develop hydrogel-based bone regeneration materials. In this study, we engineered a self-assembled chelating peptide hydrogel loaded with an osteogenic metal ion cluster extracted from the processed pyritum decoction, including Fe2+, Cu2+, Zn2+, Mn2+, Mg2+, and Ca2+ ions, named processed pyritum hydrogel (PPH). We demonstrated that as a reservoir of beneficial metal ion clusters in bone regeneration, PPH has been shown to regulate a variety of genes in the process of bone regeneration. These genes are mainly involved in extracellular matrix synthesis, cell adhesion and migration, cytokine expression, antimicrobial and inflammation. Therefore, PPH accelerated the progress of various bone healing stages, and shortened the bone healing cycle by 4 weeks. Our investigation outcomes showed that the engineered metal ion cluster hydrogel is a novel, simple, and commercializable bone-regenerating hydrogel with potential clinical use.
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Regeneração Óssea , Hidrogéis , Hidrogéis/química , Osteogênese , Peptídeos , Osso e OssosRESUMO
An ultra-high performance liquid chromatography-tandem mass spectrometry(UHPLC-MS/MS) method was established for the determination of active components of Sarcandrae Herba, and applied to the pharmacokinetics study of multiple dosage forms. After SD rats were administered by gavage with three dosage forms [Sarcandrae Herba extract, commercial Sarcandrae Herba Guttate Pills, and polydopamine guttate pills loaded with active components of Sarcandrae Herba(PDA-Sg Guttate Pills)], blood samples were collected from the inner canthus at different time points. After protein precipitation, plasma samples were separated on ACQUITY UPLC C_(18) column(2.1 mm×100 mm, 1.7 µm). The mobile phase consisted of water containing 0.2% formic acid and acetonitrile in gradient elution. The negative ions were measured simultaneously in the multi-reaction monitoring(MRM) mode. The pharmacokinetic parameters were calculated and fitted by DAS 2.0. All four components could be detected in the plasma of rats in each group at each time point except the neochlorogenic acid and cryptochlorogenic acid in the Sarcandrae Herba extract group. The guttate pills group showed a significant increase in drug content at each time point. The exposure of the main components of Sarcandrae Herba in blood was effectively increased by PDA-drug loading effect in PDA-Sg Guttate Pills(The AUC_(0-24 h) of neochlorogenic acid, cryptochlorogenic acid, isaziridin and rosmarinic acid reached 2.45, 32.90, 1.54, 4.81 times that of the commercial guttate pills). This study proves the measurability of the above-mentioned multi-component in vitro-in vivo delivery process. The pharmacokinetic study has shown that PDA-Sg Guttate Pills can effectively delay the elimination time and improve the bioavailability of the four components, which can provide theoretical data for the production of the drug.
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Medicamentos de Ervas Chinesas , Espectrometria de Massas em Tandem , Animais , Cromatografia Líquida de Alta Pressão/métodos , Medicamentos de Ervas Chinesas/farmacocinética , Indóis , Polímeros , Ratos , Ratos Sprague-Dawley , Reprodutibilidade dos Testes , Espectrometria de Massas em Tandem/métodosRESUMO
OBJECTIVE: To investigate whether anterior selective fusion (ASF) could save more distal fusion segments compared with posterior approach in the treatment of Lenke type 5 adolescent idiopathic scoliosis with long term follow-up. METHODS: A retrospective cohort study. From 2008 to 2011, 22 AIS girls with Lenke type 5 who underwent ASF or posterior selective fusion (PSF) with more than 8-year follow-up, were extracted from the database. 13 girls in the ASF group had an average age of 14.3 ± 1.3 years and Risser sign of 3.3 ± 1.1; 9 PSF girls had an average age of 16.2 ± 3.6 years and Risser sign of 3.8 ± 1.5. The radiographic outcome was compared between groups preoperatively, 6-month postoperatively, 8-year postoperatively and at last follow-up (>8 years). RESULTS: The average follow-up duration was 8.7 ± 0.4 (ASF) and 8.8 ± 0.5 (PSF) years, respectively. There was no significant difference at baseline in age, Risser sign and preoperative curve pattern in the coronal and sagittal plane between the groups (P > 0.05). The ASF group had significantly shorter fusion segments (5.1 ± 0.6 vs. 7.0 ± 1.3) and decreased upper instrumented vertebra (UIV) (T11 ± 0.8 vs. T10 ± 0.8) than the PSF (P < 0.05); while no significant difference was found in the lower instrumented vertebra (LIV) and distal reserved segments (P > 0.05), which suggested that ASF could shorten the fusion segments by lowering UIV. The distal compensatory curve in the ASF group (9.0° ± 3.9°) was significantly larger than in the PSF group (3.3° ± 2.4°, P = 0.003), despite of no significant difference in the incidence of coronal imbalance (P > 0.05), indicating that both two approaches could obtain satisfactory correction in the coronal plane. In the sagittal plane, PSF patients had significantly larger lumbar lordosis (LL, 59.1° ± 10.5°), thoracic kyphosis (TK, 37.2° ± 13.3°) and proximal junctional angle (PJA, 13.3° ± 6.1°) at the last follow-up than the ASF (LL: 43.4° ± 9.4°; TK: 20.7° ± 8.4°; PJA: 4.7° ± 3.4°; P < 0.05), but without significant difference in proximal junctional kyphosis (PJK) and sagittal vertical axis (SVA) (P > 0.05). After controlling for age, Risser sign, and radiographic parameters related to the primary curve pattern, shorter fusion segments and more distal reserved segments still remained significant in the ASF group with greater Risser sign (P < 0.05). No major intra- or post-operative complications occurred. CONCLUSIONS: Both ASF and PSF could obtain satisfactory coronal and sagittal correction for Lenke 5 AIS; compared with PSF, ASF could shorten the fusion segments by lowering UIV, and save more distal fusion segments only in patients with greater skeletal maturity.
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Vértebras Lombares/cirurgia , Escoliose/cirurgia , Fusão Vertebral/métodos , Vértebras Torácicas/cirurgia , Adolescente , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Extreme lumbar spinal stenosis was thought to be a relative contraindication for lateral lumbar interbody fusion (LLIF) and was excluded in most studies. This is a retrospective study to analyze the radiographic and clinical outcome of LLIF for extreme lumbar spinal stenosis of Schizas grade D. METHODS: For radiographic analysis, we included 181 segments from 110 patients who underwent LLIF between June 2017 and December 2018. Lumbar spinal stenosis was graded according to Schizas' classification. Anterior and posterior disc heights, disc angle, foramen height, spinal canal diameter and central canal area were measured on CT and MRI. For clinical analysis, 18 patients with at least one segment of grade D were included. Visual analogue scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate clinical outcome. Continuous variables were compared using Student's t-test, with P-values < 0.05 considered to indicate statistically significant differences. RESULTS: Among the 181 segments included for radiological evaluation, there were 23 grade A segments, 37 grade B segments, 103 grade C segments and 18 grade D segments. Postoperatively, the average change of midsagittal canal diameter of grade D was significantly greater than that of grade A, and not significantly different compared to grades B and C. As to the average change of disc height, bilateral foraminal height, disc angle and central canal area (CCA), grade D was not significantly different from the others. The average postoperative CCA of grade D was significantly smaller than the average preoperative CCA of grade C. Eighteen patients with grade D stenosis were followed up for an average of 19.61 ± 6.32 months. Clinical evaluation revealed an average improvement in the ODI and VAS scores for back and leg pain by 20.77%, 3.67 and 4.15 points, respectively. Sixteen of 18 segments with grade D underwent posterior decompression. CONCLUSION: The radiographic decompression effect of LLIF for Schizas grade D segments was comparable with that of other grades. Posterior decompression was necessary for LLIF to achieve a satisfactory clinical outcome for extreme lumbar spinal stenosis of Schizas grade D.
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Descompressão Cirúrgica/métodos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Fusão Vertebral/métodos , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Escala Visual AnalógicaRESUMO
Bismuth (Bi) has been demonstrated as a promising anode for Na-ion batteries (NIBs) because it has high gravimetry (386 mA h g-1) and volumetric capacity (3800 mA h cm-3). However, Bi suffers from large volume expansion during sodiation, leading to poor electrochemical performance. The construction of a nanostructure with sufficient void space to accommodate the volume change has been proven effective for achieving prolonged cycling stability. However the excessive void space will definitely decrease the volumetric energy density of the battery. Herein, we design optimized Bi@Void@C nanospheres (Bi@Void@C-2) with yolk-shell structure that exhibit the best cycling performance and enhanced volumetric energy density. The optimized void space not only could buffer the volume change of the Bi nanosphere but also could keep the high volumetric energy density of the battery. The Bi@Void@C-2 shows an excellent rate capacity of 173 mA h g-1 at ultrahigh current density of 100 A g-1 and long-cycle life (198 mA h g-1 at 20 A g-1 over 10â¯000 cycles). The origin of the superior performance is achieved through in-depth fundamental studies during battery operation using in situ X-ray diffraction (XRD) and in situ transmission electron microscope (TEM), complemented by theoretical calculations and ex situ TEM observation. Our rational design provides insights for anode materials with large volume variation, especially for conversion type and alloying type mechanism materials for batteries (i.e., Li-ion batteries, Na-ion batteries).
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We report a general metal-catalyzed thermal polymerization strategy for the preparation of atomically dispersed catalysts that consist of isolated metal atoms (Fe, Co and Ni) hosted by a polymer-like carrier containing phenanthroline substructure. The prepared atomically dispersed cobalt catalysts exhibit high selectivity, activity, and reusability in catalyzing aromatic alkane oxidation.
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The present study was designed to develop and validate a sensitive and reliable ultra high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) method to separate and identify the chemical constituents of Qixue Shuangbu Tincture (QXSBT), a classic traditional Chinese medicine (TCM) prescription. Under the optimized UPLC and QTOF/MS conditions, 56 components in QXSBT, including chalcones, triterpenoids, protopanaxatriol, flavones and flavanones were identified and tentatively characterized within a running time of 42 min. The components were identified by comparing the retention times, accurate mass, and mass spectrometric fragmentation characteristic ions, and matching empirical molecular formula with that of the published compounds. In conclusion, the established UPLC-QTOF/MS method was reliable for a rapid identification of complicated components in the TCM prescriptions.
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Cromatografia Líquida de Alta Pressão/métodos , Medicamentos de Ervas Chinesas/química , Espectrometria de Massas por Ionização por Electrospray/métodosRESUMO
An analytical method has been developed for the determination of traces of Zn, Mn, Na, K, Ca, Mg, Ni, Pb, Se, Fe, Cu, Al, B, Ti, Sn, Hg, and Li in nine herbal drugs for nourishing blood by ICP-AES. The data showed that nine herbal drugs for nourishing blood were abundant in the contents of major and trace elements which are healthy for human body, including the trace elements with higher contents, such as Fe, Se, Ni, Mn, and Zn, which are well known for nourishing blood. Elements (macro-elements, essential elements, non-essential elements, and toxic elements) classified in nine herbal drugs for nourishing blood were illustrated in cylindrical histograms. Principal component analysis and hierarchical cluster analysis were applied to the data matrix to evaluate analytical results. The results of hierarchical cluster analysis showed that dendrogram obtained by Ward's method of hierarchical cluster analysis for seventeen variables and nine samples mainly displayed three clusters. After optimizing the microwave digestion technology, the recoveries of seventeen elements were in the ranges from 97.89% to 103.25% and the RSDs were all lower than 3.0%. ICP-AES combined with microwave digestion is accurate and precise in determining major and trace elements in nine herbal drugs for nourishing blood.
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The primary processing is important links and closely related to the quality of traditional Chinese medicinal materials, and is not only cleaning of remove the non-officinal parts, drying for termination the physiological status of organisms, but also retaining the most active substances, decreasing the toxic components, and promoting the transformation among chemical ingredients through primary processing. So the traditional primary processing endows with characters, quality, specifications and properties of traditional Chinese medicine, and embodies some important science truth. The traditional primary processing method and technology systems are derived from the long-term practices and experiences, which are distinctive, colorful, diverse, and scientific, which are helpful to development and utilization of traditional Chinese medicine resources. This paper systemically expounds the research status of the Chinese medicine processing method, summarizes the problems in the primary processing of traditional Chinese medicinal materials research, and prospects its bright future.
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Química Farmacêutica/métodos , Medicamentos de Ervas Chinesas/química , Química Farmacêutica/tendências , Medicamentos de Ervas Chinesas/farmacologia , Medicina Tradicional ChinesaRESUMO
Metabonomics is a new method to study on the metabolic network and the relationship between body and environment, which conforms to the way of traditional Chinese medicine (TCM) research. In the study process of modernization of traditional Chinese medicine, effectively conjunction with metabonomics method will facilitate the integration of TCM with modern biological science and technology, and promote the modernization of TCM. This paper introduce the application of metabonomics in the research of toxicity mechanism of TCM, compatibility mechanism of TCM formula, pharmacology effect of TCM and processing mechanism of TCM. This paper summarize the problems in the TCM metabonomics research and prospect its bright future.
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Medicamentos de Ervas Chinesas/análise , Medicamentos de Ervas Chinesas/metabolismo , Medicina Tradicional Chinesa/tendências , Metabolômica/tendências , Animais , Tratamento Farmacológico , Medicamentos de Ervas Chinesas/efeitos adversos , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Medicina Tradicional Chinesa/métodos , Metabolômica/métodosRESUMO
OBJECTIVE: To evaluate the outcomes of treating patients with proximal and middle one-third humeral fractures treated with lateral distal tibial helical plate. MATERIALS AND METHODS: From June 2004 to January 2009, 12 patients (8 men, 4 women: average age: 46.8 years, range: 25-63) with proximal and middle one-third humeral fractures were treated with open reduction and internal fixation using lateral distal tibial helical plate. Standard anterior-posterior and lateral radiographs were obtained and evaluated. Shoulder function was assessed according to the Constant-Murley score. RESULTS: At follow-up (average: 18 months), all fractures had healed (average: 15 weeks, range: 9-23). There were no cases of intraoperative complications, implant failures, infections, or iatrogenic intra- or post-operative nerve lesions. All patients achieved at least 100° of abduction by 3 months post-surgery and full range of movement by 12 months post-surgery, with the exception of one patient who had an impingement symptom with moderate loss of abduction and external rotation. The average Constant-Murley score was 88 points at 12-month follow-up. According to Constant-Murley score, 28% of patients had excellent functional outcome, 64% had good outcome, 8% had moderate outcome, and none had failure. According to self-reporting, all patients had returned to the pre-injury level of activity. CONCLUSIONS: The lateral distal tibial helical plate promotes bone healing and minimizes the damage to the deltoid muscle insertion region, thereby facilitating rapid and good functional recovery. In addition, the helical plate design avoids affecting sliding of the biceps tendon and maintains good reduction position. The lateral distal tibial helical plate is an effective surgical option for proximal and middle one-third humeral fractures.
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Spontaneous discitis is unusual and typically affects children. Hematogenous delivery of an infectious organism is the likely main cause. Common treatment method including conservative and surgical treatments, which also needs prolonged antimicrobial therapy based on an effective inhibitory concentration, can be achieved on the local disc space. Intradiscal antibiotic concentration was measured after the disc was harvested after preventive administration of antibiotics in previous studies. On the one hand the disc cannot simulate the infection situation when the inflammation leads to end plate destruction, vascular invasion and increase of permeability. On the other hand antibiotic concentrations were measured in vitro which cannot tell the actual situation in vivo. It is necessary to find a reliable evaluation method to decide whether the antibiotic can penetrate and make an effective inhibitory concentration in the local disc at the beginning of the treatment in vivo. Systemic antibiotics like nutrients enter and leave the disc by the only way of passive diffusion. The postcontrast MRI has been widely used as a noninvasive method of studying transport into the disc. The enhancement following contrast administration can be measured in T1 sagittal MR images by placing suitable cursors and evaluating the signal intensity (SI) of the region. Therefore we hypothesise that serial postcontrast MRI can be used to measure antibiotic concentration in the infected intervertebral disc in vivo. If the hypothesis is verified, we can better determine the choice of antibiotics and antibiotic treatment regime at the beginning of the treatment to improve the treatment success rate.
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Antibacterianos/farmacocinética , Discite/tratamento farmacológico , Antibacterianos/uso terapêutico , Humanos , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To compare the outcome of two minimally invasive internal fixed methods for the treatment of distal tibio-fibula fractures. METHODS: The clinical data of 50 patients with distal tibio-fibula fractures from March 2006 to March 2009 was analyzed retrospectively. Twenty-eight patients were treated with minimally invasive percutaneous locking compression plate fixing tibia combining elastic stable intramedullary nailing fixing fibular (Group P + E). There were 18 male and 10 female patients with a mean age of (45 ± 6) years. Twenty-two patients were treated with interlocking intramedullary nail fixing tibia combining elastic stable intramedullary nailing fixing fibular (Group N + E). There were 12 male and 10 female patients with a mean age of (43 ± 9) years. The index of peri-operation, pain score at 3 d postoperative, bone union time, the clinical outcomes and complications postoperative were statistically compared. RESULTS: There were no statistical significance on operation time, blood loss perioperative and pain score at 3 d postoperative. Bone union time in Group N + E was significantly longer than in Group P + E [(21.1 ± 3.0) weeks vs. (15.4 ± 2.9) weeks]. Meanwhile, the function of ankle score (44.3 ± 1.7 vs. 41.8 ± 2.5) and the line of foot score (8.6 ± 2.3 vs. 6.8 ± 3.6) in Group P + E were respectively significantly higher than that in Group N + E. However, there were no statistical difference on ankle pain, buckling add stretch restricted, turn inward add evaginate restricted and the rate of good and fair between the two groups. There were 3 cases of complications postoperation in Group P + E, significantly less than the 8 cases of Group N + E. CONCLUSIONS: Minimally invasive percutaneous locking compression plate fixing tibia combining elastic stable intramedullary nailing fixing fibular shows superiority in treatment of distal tibio-fibula fractures. However, interlocking intramedullary nail fixing tibia combining elastic stable intramedullary nailing fixing fibular has the advantages in worse soft tissue and multi-step tibio-fibula fractures.
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Fíbula/lesões , Fixação Interna de Fraturas/métodos , Fraturas da Tíbia/cirurgia , Adulto , Pinos Ortopédicos , Placas Ósseas , Feminino , Seguimentos , Fraturas Ósseas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Spontaneous infectious spondylodiscitis (SIS) is an uncommon condition. The purpose of this retrospective study of 10 adult patients (6 males and 4 females, average age 52 years), all with lumbar SIS and epidural abscess, was to analyze the efficacy of single-stage posterior debridement plus single-level interbody grafting with autologous bone, and transpedicular screw-rod instrumentation. The mean follow-up period was 43 months, with a minimum of 30 months. The back pain was relieved within 3 to 8 days after surgery. Neurologic deficits, present in 5 cases, all improved. Solid fusion was achieved at 6 months in all 10 cases. The mean VAS for pain improved from 7.5 to 1.6, the mean Oswestry Disability Index from 57.8% to 8.1%. The mean physical component of SF-36 (PCS) improved from 32.4% to 54.7%, the mean mental component of SF-36 (MCS) improved from 33.8% to 57.2%. All these changes were significant (p < 0.001). No recurrence of infection was noted. The outcome was quite satisfactory in terms of fusion rate and quality of life.
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Infecções Bacterianas/complicações , Desbridamento/métodos , Discite/cirurgia , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Espondilite/cirurgia , Adulto , Idoso , Discite/diagnóstico , Discite/microbiologia , Abscesso Epidural/complicações , Abscesso Epidural/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espondilite/microbiologiaRESUMO
OBJECTIVE: To study the clinical effects of surgical treatment of displaced intra-articular fractures of the calcaneus in elderly patients, and to discuss the operative indications. METHODS: From January 2000 to December 2007, 24 elderly patients with 26 fractures underwent open reduction and internal fixation for a displaced intra-articular fracture of calcaneus, which included 18 feet of 18 males and 8 feet of 6 female, with an average age of 67 years (range, 60 to 75 years). According to Sanders classification based on CT scanning, 13 fractures were rated as type II, 12 as type III and 1 as type IV. Böhler angle and Gissane angle were measured preoperatively and postoperatively and foot function was assessed with Maryland foot score system. RESULTS: Twenty-four cases with 26 feet were followed up for an average of 18.4 months (range, 12 to 26 months). Mean Böhler angle was (10.4 +/- 8.2) degrees preoperatively and (27.8 +/- 7.4) degrees postoperatively and mean Gissane angle was (136.5 +/- 10.3) degrees preoperatively and (124.3 +/- 4.2) degrees postoperatively. The difference between preoperative and postoperative values was found with statistically significant (P < 0.05). The results were excellent in 5 feet, good in 16 feet, fair in 4 feet and poor in 1 foot. There were 3 cases of wound necerosis, 2 cases of wound infection, 1 case of sural nerve injury and 6 cases of posttraumatic subtalar arthritis complications. CONCLUSION: Good clinical result could be obtained with surgical treatment in elderly patients with displaced intra-articular fractures of the calcaneus. Open reduction appears to be an acceptable method of treatment for displaced calcaneal fractures in elderly patients if they have good general conditions.
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Calcâneo/lesões , Fraturas Intra-Articulares/cirurgia , Idoso , Calcâneo/fisiopatologia , Feminino , Humanos , Fraturas Intra-Articulares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologiaRESUMO
OBJECTIVE: To study the effectiveness of retinoic acid on induction of osteoporotic rats treated by either alendronate or qianggu capsules and co-administration. METHODS: Sixty-five female SD rats were treated with retinoic acid 80 mg x kg(-1) x d(-1) by gastric lavage for 15 days. Then 5 rats were confirmed cases of osteoporosis and the remaining 60 were randomly divided into 4 groups 15 each: (1) control group with NS 8 ml x kg(-1) x w(-1); (2) alendronate group with alendronate 40 mg x kg(-1) x w(-1); (3) qianggu group with qianggu capsules 90 mg x kg(-1) x d(-1); (4) co-medicated group with alendronate 40 mg x kg(-1) x w(-1) and qianggu capsules 90 mg x kg(-1) x d(-1). Five rats in each group were sacrificed at week 2, 4 and 6 respectively to carry out the biomechanic tests, histopathologic examination and bony callus volume calculation. RESULTS: Biomechanical properties of femur changed significantly after the treatment by alendronate or qianggu capsules and co-medication as compared with that of NS after 4 weeks (P < 0.05); the bony callus were larger when treated by alendronate (P < 0.05) and smaller by qianggu capsules (P > 0.05); the bone trabecula formed and rebuilding were slower by alendronate and quicker by qianggu capsules. CONCLUSION: Alendronate or qianggu capsules and co-medication can improve biomechanical properties of femur by retinoic acid on induction of osteoporotic rats. Qianggu capsules can improve bone union.