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【Objective】 To evaluate the clinical efficacy of utilizing auxiliary steel plates in conjunction with autologous platelet-rich plasma (PRP) therapy for the treatment of bone non-union following intramedullary fixation of long shaft fractures in the limbs. 【Methods】 From January 2020 to September 2022, 33 patients with non union after intramedullary fixation of long shaft fractures of the limbs admitted to the orthopedic trauma ward of the 960th Hospital of the PLA Jonit Logistics Support Force were selected as the research subjects, including 28 males and 5 females.The age range was 22 to 55 years, with an average of (37.2±6.7) years. The patients were divided into the experimental group (n=15) and the control group (n=18) in order of admission. All patients retained intramedullary fixation, and the fracture end was fixed with reconstruction steel plates. According to the random number table method, 15 cases in the experimental group were treated with autologous iliac bone transplantation combined with intraoperative and postoperative autologous PRP. The activated autologous PRP was fully fused with the patient′s autologous iliac bone during surgery and transplanted to the bone defect site.Ultrasound guidance was used to accurately locate the location. Autologous PRP was injected 10 mL/(person) occasion on the 14 th and 28 th day after surgery respectively. Eighteen cases in the control group received the treatment of autologous iliac bone transplantation at the bone defect site only. The clinical healing status of fractures between the two groups of patients were observed and compared. 【Results】 All 33 patients were followed up for a complete period of 9 to 30 months, with an average of (11.8±2.7) months. Compared with the control group, the clinical fracture healing time (months) was 5.25±1.18 vs 7.27±1.38 (P<0.05); The healing rate was 93.3%(14/15)vs 61.1%(11/18) (P<0.05). 【Conclusion】 The combination of intraoperative and postoperative use of autologous PRP and auxiliary steel plates could promote the healing of bone non union after intramedullary fixation of long shaft fractures in the limbs, which is beneficial for early functional exercise of patients.
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BACKGROUND:Previous studies have shown that silent mating-type information regulator 2 homolog 1(SIRT1)-mechanistic target of rapamycin(mTOR)signaling plays an important role in the progression of osteoarthritis.Emodin has a protective effect on osteoarthritic chondrocytes. OBJECTIVE:To investigate the effects of emodin on the proliferation,apoptosis and oxidative stress of osteoarthritic chondrocytes based on the SIRT1-mTOR signaling. METHODS:Rat chondrocytes were isolated and cultured in vitro.Osteoarthritic chondrocyte model in vitro was induced by 10 ng/mL interleukin-1β.Cell counting kit-8 method was used to determine the viability of rat chondrocytes treated with 0,20,40,80,120,160 μmol/L emodin,and the appropriate concentration of emodin was selected.Rat chondrocytes isolated and cultured in vitro were randomly divided into control group,model group,low-dose emodin group,high-dose emodin group,EX527 group,and high-dose emodin+EX527 group.In vitro osteoarthritis model was constructed by induction of 10 ng/mL interleukin 1β in all groups except the control group.The cells in the latter four groups were correspondingly treated with emodin or/and EX527.The proliferation and apoptosis of chondrocytes in each group were detected by cell counting kit-8,Edu staining and flow cytometry respectively.The relative content of reactive oxygen species and the levels of malondialdehyde,superoxide dismutase,catalase,and glutathione peroxidase in chondrocytes of rats in each group were measured with the kit.The expression of proteins related to cell matrix degradation,apoptosis and the SIRT1-mTOR pathway-related proteins in each group were detected by western blot. RESULTS AND CONCLUSION:Compared with the control group,the survival rate of chondrocytes,the positive rate of Edu,the levels of superoxide dismutase,catalase,and glutathione peroxidase,and the expression of Bcl-2 and SIRT1 proteins in the model group were decreased,while the apoptosis rate,the relative content of reactive oxygen species,the level of malondialdehyde,the expression of Bax,matrix metalloproteinase 3,matrix metalloproteinase 9 proteins,and p-mTOR/mTOR were increased(P<0.05).Compared with the model group,the survival rate of chondrocytes,the positive rate of Edu,the levels of superoxide dismutase,catalase,and glutathione peroxidase,and the expression of Bcl-2 and SIRT1 proteins in the low-and high-dose emodin groups were increased,while the apoptosis rate,the relative content of reactive oxygen species,the level of malondialdehyde,the expression of Bax,matrix metalloproteinase 3,matrix metalloproteinase 9 proteins,and p-mTOR/mTOR were decreased(P<0.05).Compared with the low-and high-dose emodin groups,the indexes of EX527 group showed the opposite trend(P<0.05).Compared with the high-dose emodin group,the survival rate of chondrocytes,the positive rate of Edu,the levels of superoxide dismutase,catalase,and glutathione peroxidase,and the expression of Bcl-2 and SIRT1 proteins in the high-dose emodin+EX527 group were decreased,while the apoptosis rate,the relative content of reactive oxygen species,the level of malondialdehyde,the expression of Bax,matrix metalloproteinase 3,matrix metalloproteinase 9 proteins,and p-mTOR/mTOR were increased(P<0.05).To conclude,emodin can inhibit oxidative stress of osteoarthritic chondrocytes by activating the SIRT1-mTOR signaling,thereby promoting chondrocyte proliferation and reducing apoptosis.
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Objective To develop improved enzymatic creatinine(Cr)assay reagents (self-R&D),and to investigate their appli-cation on serum detection by comparing with imported commercial Cr reagents(enzymatic Cr reagents from Toyobo)Methods En-zymatic method was used to evaluate the effect of every component and different concentrations of reagents on Cr assay by detecting the alteration of absorbance of Cr before or after the reaction.Meanwhile,the blank absorbance and analysis sensitivity of self-R&D and imported reagents,the technical indicators of precision,linearity,as well as method comparison of self-R&D reagents,were de-tected on the same automatic biochemical analyzer.Results The blank absorbance of self-R&D reagents was 0.009,and the detec-tion sensitivity was 0.13,better than that of imported Cr reagents.The coefficient of variation (CV)of high and low values of ser-um of self-R&D reagents were 1.5%,and 1.1%,respectively.The linear range was 0-2 850 μmol/L and the method comparison result was Y =0.98X +1.15 (r =0.999).The expected bias was less than the allowable error region.Using relative deviation≥10% as an index to evaluate the existence of significant interference,it shows that 35 mmol/L of creatine,3.42 mmol/L of biliru-bin,0.03 g/L of vitamin C,5 g/L of hemoglobin and 1450 FTU chyle in both low and high concentration serum samples did not interfere with the test result.Conclusion The quality of self-R&D reagents was good,and there was a good relativity between self-R&D reagents and imported Cr reagents with excellent quality.This indicates the self-R&D reagents could satisfy the application requirements of the clinics.
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BACKGROUND:Traumatic soft tissue defects of the limbs are usual y accompanied with the exposure of tendon, joint capsule, bone or internal fixator, which can be reconstructed by skin flap. Previous research has shown that it is an important method to repair traumatic tissue defects with flaps. However, rarely research reports perioperative management about flap bed so far. OBJECTIVE:To explore the perioperative strategy for repairing traumatic soft tissue defects with revascularized flaps. METHODS:Total y 94 cases undergoing secondary skin flap repair were enrol ed. Intraoperative debridement using tourniquet was performed, and the wound was washed with mass of physiological saline. Whether the tissues, including bone, tendon, joint capsule and internal fixator, were reserved or not depended on their viability, and then the flaps were harvested to repair defects, and drainage was placed properly at last. RESULTS AND CONCLUSION:The flaps survived in al cases. Exudation occurred in 5 cases with the exposure of bone, and 28 cases with the exposure of tendon or joint capsule healed normal y. No complications were associated with the reservation of the internal fixators, but delayed-union occurred in three cases and nonunion in one case. These findings indicate that the perioperative treatment of the application of skin flap is worthy of attention. Careful debridement, advisable choice of the flap, efficient drainage and using antibiotic normatively are al keys. Treatment of the bone, tendon, joint capsule and internal fixator which are exposed should not only weigh the advantage and disadvantage, but also relax the indication of reserving them.
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Objective To evaluate the anti-interference performance of D-3-hydroxybutyrate (D3H ) reagent kit by using the NCCLS document EP7-A2 and to improve its anti-interference performance .Methods The anti-interference evaluation test of D3H kit was performed according to NCCLS document EP7-A2 and its anti-interference performance was improved by adding vitamin C oxidase .Results 342 mol/L free bilirubin ,342 mol/L conjugated bilirubin ,1 450 FTU chyle and 5 g/L hematoglobin had no inter-ference on the high concentration D3H detection ,0 .03 g/L vitamin C interfered with the low and high concentration D3H detection . The dosage-effect experiment results showed that vitamin C produced the linear positive interference effect on D 3H detection . Adding 2 500 U/L of vitamin C oxidase could antagonize the interference of vitamin C on detection .Conclusion Vitamin C can in-terfere with the D3H detection and adding vitamin C oxidase in reagent can antagonize its interference .
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BACKGROUND:It is exhibit that nerve growth factor(NGF)and its receptor expresses in normal bone tissue and callus,the local administration of exogenous NGF can promote the healing of fractures.When fracture following peripheral nerve injury happened,the quality of callus significantly affected.OBJECTIVE:To verify the effect of NGF on tibia with peripheral nerve injury in early-stage fracture healing.DESIGN,TIME AND SETTING:A randomized grouping design,animal controlled experiment was performed at the Experimental Animal Center,General Hospital of Jinan Military Area Command of Chinese PLA between May and November 2007.MATERIALS:Forty-eight male Wistar rats,weighting(220?20)g;NGF injection was produced by Xiamen Road of Beijing University Bio-Engineering Co.,Ltd.(Batch number:20070502).METHODS:Forty-eight male Wistar rats were randomly divided into 4 groups,with 24 limbs in each group.Rats in the sodium chloride group were injected sodium chloride after tibia fracture.Rats in the nerve injury with sodium chloride group were injected sodium chloride after tibia fracture combined with nerve injury.In the NGF group,rats were injected NGF after tibia fracture.Rats in the nerve injury with NGF group were nerve injury plus tibia fracture plus NGF.First,the mid-point department circumference of tibia was measured,and then a wedge-shaped groove on the upper tibia anterior was got,and then femoral nerve about 10 mm at the level of the inguinal ligament was cut.Tibia slotted for the opposite,exposed,but not to remove nerve.Turn to prone position,executed the sciatic nerve with a length of about 10 mm on the side of femoral nerve resection at the same time.Contralateral incision exposed.After the surgery,sodium chloride group and nerve injury with sodium chloride group were injected with physiological saline,0.1 mL/limb per day.The rats in the NGF group and nerve injury with NGF group were injected 0.1 mL(0.2 U)NGF per day.MAIN OUTCOME MEASURES:The circumference of crus,X-ray film,wet weight of specimen,and callus metrology observation was measured at weeks 2 and 4 after operation.RESULTS:①The crus shrunk more obvious after never injury,however,NGF promoted the muscle restoration.②The wet weight of specimen and callus at the nerve injury side was more than contralateral side.③There were more callus at the never injury side of nerve injury with sodium chloride group and nerve injury with NGF group than contralateral side at the 2 and 4 weeks,but there were more osteoid,which lacking of normal bone trabecula structure.The callus quantity of NGF group and nerve injury with NGF group had small amount of high density callus with orderly arrayed bone trabecula.CONCLUSION:During fracture,whether nerve injury or not,local injection of NGF can have a passive effect.