[Application of intermittent flap opening in L-shaped surgical incision of calcaneal fracture].

OBJECTIVE: To explore clinical effect of intermittent flap opening technique in L-shaped incision of calcaneal fracture. METHODS: From January 2017 to January 2019, 48 patients with Sanders typeⅡ to Ⅳ calcaneal fractures were treated by open reduction and internal fixation. According to different flap opening techniques, the patients were divided into control group and observation group, 24 patients in each group. In observation group, there were 17 males and 7 females, aged from 20 to 60 years old with an average of(45.12±9.56) years old;7 patients were typeⅡ, 10 patients were type Ⅲ and 7 patients were type Ⅳ according to Sanders classification;3 patients were C0, 16 patients were C1 and 5 patients were C2 according to Tscherne-Gotzen soft-tissue assessment;treated with intermittent flap technique. In control group, there were 19 males and 5 females aged from 20 to 60 years old with an average of (47.32±10.67) years old;7 patients were typeⅡ, 11 patients were type Ⅲ and 6 patients were type Ⅳ according to Sanders classification;2 patients were C0, 18 patients were C1 and 4 patients were C2 according to Tschemc-Gotzen soft-tissue assessment;treated with static flap opening technique. Operation time, flap retraction time, changes of Böhler angle and Gissane angle before and after operation at 3 days, and occurrence of incision complications were observed and compared between two groups. RESULTS: All patients were followed up from 3 to 6 months with an average of(4.52±1.01) months. There were no significant differences in operation time, changes of Böhler angle and Gissane angle before and after operation at 3 days between the two groups(P>0.05);there was statistical difference in flap retraction time between two groups(P<0.05). Occurrence of incision complications in observation group was significantly lower than that in control group (P<0.05). CONCLUSION: Intermittent flap opening technique is superior to static opening technique in reducing incision complications of lateral "L" approach of calcaneus. Single Kirschner wire opening does not affect the exposure, reduction and fixation of fracture during operation.

[Treatment of acute non-displaced scaphoid fracture of wrist with syringe needle-guided percutaneous cannulated headless hollow compression screw internal fixation].

OBJECTIVE: To investigate the clinical efficacy of needle-guided percutaneous cannulated compression screw fixation in the treatment of acute non-displaced scaphoid fracture of wrist. METHODS: The clinic data of twenty-eight patients with acute non-displaced scaphoid fracture from January 2014 to January 2019 were analyzed retrospectively. According to the intraoperative method of placement of cannulated screw, they were divided into Guide group(16 patients)and Conventional group(12 patients). There were 13 males and 3 females in Guide group, aged from 20 to 60 years old with an average of(31.42±9.71)years old;5 patients were classified as type A2, 3 patients were classified as type B1 and 8 patients were classified as type B2 according to Herbert classification;they were treated with percutaneous cannulated compression screw fixation under the guidance of needle. There were 11 males and 1 female in Conventional group, aged from 23 to 61 years old with an average of(30.51±7.52)years old;5 patients were classified as type A2, 2 patients were classified as type B1 and 5 patients were classified as type B2 according to Herbert classification;they were treated with conventional percutaneous cannulated compression screw fixation. The operation time, screw angle relative to the longitudinal axis of the scaphoid and wrist function score were assessed and compared between the two groups. RESULTS: A total of 28 patients were followed up from 20 to 45 months with an average of (33.00±8.72) months. None of patients had intraoperative complication and incision infection. These patients returned to work gradually 2 weeks after operation, and all fractures healed within 12 weeks. The operation time in the Guide group was significantly less than that in the Conventinal group(P<0.05). Screw angle relative to the longitudinal axis of the scaphoid in the Guide group was significantly smaller than that in the Conventional group(P<0.05). There was no significant difference in Mayo wrist function scores at the last follow-up between the two groups(P>0.05). During the follow-up period, none of the 28 patients showed internal fixation displacement, arthritis, scaphoid necrosis and other complications. CONCLUSION: In the treatment of acute non-displaced scaphoid fractures, the operation time of needle-guided percutaneous cannulated headless compression screw fixation is significantly shorter than that of conventional percutaneous screw fixation, and the screw axis is easier to be parallel to the longitudinal axis of the scaphoid.

[Selective U-shaped osteotomy of lateral tibial condyle for the treatment of collapse and comminuted fracture of lateral tibial plateau].

OBJECTIVE: To explore methods and clinical effects of selective U-shaped osteotomy of lateral tibial condyle in treating collapse and comminuted fracture of lateral tibial plateau. METHODS: From January 2014 to October 2019, 15 patients with collapse and comminuted fracture of lateral tibial plateau were treated by selective U-shaped osteotomy of lateral tibial condyle, including 9 males and 6 females. The age of patients ranged from 25 to 70 years old, with an average age of (38.5±7.7) years old. According to ABC classification of condyle fracture of tibial plateau lateral, there were 2 cases of type A, 6 cases of type B, 4 cases of type BC and 3 cases of type C. Five patients were combined with medial plateau fracture, 8 patients were combined with left knee fracture and 7 patients of right knee fracture. The time of treatment after injury ranged from 1 day to 14 days with an average of (3.4±1.2) days. CT of all patients showed that lateral tibial plateau collapsed more than 2 mm, more than 2 pieces of bones were crushed and broken, and lateral tibial condyle cortex was intact. At follow-up of 12 months after operation, Rasmussen's anatomical grading system was used to evaluate fracture reduction. Rasmussen's functional grading system were used to evaluate knee joint function. RESULTS: Selective U-shaped osteotomy was successfully complated in 15 patients at one time, and operation time ranged from 55 to 110 min, with an average time of (85.6±20.0) min. The lateral plateau operation ranged from 20 to 60 min with an average time of(30.5±10.5) min. All patients were followed up for 12 to 24 months with an average of (14.6±2.5) months. Fracture healing time was 12 to 24 weeks, with an average of (13.6±3.6) weeks. At follow-up 12 months after operation, by Rasmussen's grading system, anatomical score of knee joint ranged from 14 to 18 points, with an average score of (17.5±0.3) points, of which 13 cases were excellent and 2 cases were good. The functional score ranged from 13 points to 30 points, with an average score of (26.8±2.5) points. Among them, 12 cases were excellent, 1 case was good, 2 cases were fair. Two patients suffered 2 mm and 4 mm loss of lateral tibial plateau, 1 case of knee joint 5 ° valgus, 1 case of stiff joints (10 ° to 100 °). No common peroneal nerve injury, important vascular injury, postoperative infection, internal fixation failure and other serious complications was found. CONCLUSION: The use of selective lateral tibial condyle "U"- shaped osteotomy approach is an effective and reliable method to treat the collapse and comminuted fracture of the lateral tibial plateau. It has the advantages of simple surgical incision, direct fracture exposure, accurate repositioning and fixation, short operation time and few complications.

Theta burst stimulation for upper limb motor dysfunction in patients with stroke: A protocol of systematic review and meta-analysis.

BACKGROUND: Upper limb dysfunction is one of common sequelae of stroke which limits daily activities and decreases quality of life of patients, as well as increasing caregiving burden on families. Theta burst stimulation (TBS) is considered to be a beneficial therapy for post-stroke patients with upper limb motor dysfunction, but there is a lack of a high quality evidence. We aim to investigate the effectiveness and safety of TBS for upper limb motor dysfunction in patients with stroke. METHODS: The following databases will be searched: PubMed, EMBASE, The Cochrane Library, Web of Science, China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP) and WanFang Data from the inception to October 2019. All relevant randomized controlled trials (RCTs) using TBS to treat poststroke patients with upper limb motor dysfunction will be included. The primary outcome is Upper Limb Fugl-Meyer Assessment (UL-FMA). Secondary outcomes will include Action Research Arm Test (ARAT), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), Motor Assessment Scale (MAS), Nine Hole Peg Test (NHPT), Grip strength and other scales evaluating the upper limb motor function. Adverse effects will also be evaluated. Two reviewers will screen studies, extract data and assess the risk of bias of included studies independently. Data analysis will be conducted using Review Manager software (RevMan, version 5.3.5) and R software (version 3.6.1). RESULTS: Our SR will be conducted according to AMSTAR 2.0 and reported in compliance with PRISMA. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. CONCLUSION: Our study will provide evidence for the effectiveness and safety of theta burst stimulation for upper limb motor dysfunction in patients with stroke. ETHICS AND DISSEMINATION: This systematic review (SR) does not require formal ethical approval since no privacy health information will be included. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019142462.

Functionalization of N-arylglycine esters: electrocatalytic access to C-C bonds mediated by n-Bu4NI.

An efficient electrocatalytic functionalization of N-arylglycine esters is reported. The protocol proceeds in an undivided cell under constant current conditions employing the simple, cheap and readily available n-Bu4NI as the mediator. In addition, it is demonstrated that the mediated process is superior to the direct electrochemical functionalization.

[Prediction of drug-target interaction based on fingerprint similarity].

Drugs play the pharmacological effects by combining with target proteins. Identification of drug-target interactions is important for discovering new functions of drugs. In this paper, the target fingerprints based on molecular substructure and the drug-target similarity based on fingerprints are proposed to a random forest-based classification method, in order to identify the drug-target interactions. Experiments on enzymes, ion channels, G protein-coupled receptors and nuclear receptors proved the effectiveness of the proposed method. In addition, the proposed method is applied to predict the interactions between ingredients and targets of traditional Chinese medicines.

Electrocatalytic Minisci Acylation Reaction of N-Heteroarenes Mediated by NH4I.

An electrochemical C-H acylation of electron-deficient N-heteroarenes with α-keto acids is reported. This first electrochemical Minisci acylation reaction proceeded using NH4I as a redox catalyst. A broad N-heteroarene scope and high functional group tolerance are observed. Selective monoacylation of N-heteroarenes is achieved via control of acyl radical at a low concentration. The results of cyclic voltammetry and control experiments disclose that the electrogenerated I2 is likely the active species to initiate the oxidative decarboxylation of carboxylate anion via an acyl hypoiodite intermediate. The electrochemical Minisci acylation provides a straightforward approach for the late-stage functionalization of pharmacophores.