[Clinical application of Wide-awake technique in flexor tendon tenolysis].

OBJECTIVE: To discuss the method and effectiveness of Wide-awake technique in flexor tendon tenolysis. METHODS: The clinical data of 16 patients (22 fingers) with flexor tendon adhesion treated by Wide-awake technique for flexor tendon tenolysis between May 2019 and December 2019 were retrospectively analyzed. The patients were all male, aged from 18 to 55 years old, with an average of 35 years old. Among them, 4 cases (7 fingers) after replantation of severed fingers, 4 cases (7 fingers) after flexor tendon rupture repair, and 8 cases (8 fingers) after open reduction and internal fixation of proximal fractures. The time from the original operation to this operation was 6-18 months, with an average of 8 months. The visual analogue scale (VAS) score was used to evaluate the patient's pain during local anesthesia (when the first needle penetrated the skin), intraoperative, and 24 hours postoperatively; and the recovery of finger movement was evaluated by total finger joint active range of motion (TAM) evaluation system and Strickland (1980) standard after operation. RESULTS: Intraoperative hemostasis and anesthesia were satisfactory, and the patient could fully cooperate with the surgeon in active finger movements. There were different degrees of pain during local anesthesia (VAS score was 2-4), no pain during operation (VAS score was 0), and different degrees of pain after operation (VAS score was 1-8, 9 patients needed analgesics). All incisions healed by first intention after operation. All 16 cases were followed up 9-15 months with an average of 12 months. Finger function was significantly improved, no tendon rupture occurred. At last follow-up, the patients after proximal fracture open reduction and internal fixation were rated as excellent in 4 fingers and good in 4 fingers according to the TAM standard, and both were excellent according to the Strickland (1980) standard; and the patients after replantation of severed fingers and flexor tendon rupture repair were rated as excellent in 4 fingers and good in 10 fingers according to TAM standard, and as excellent in 6 fingers and good in 8 fingers according to Strickland (1980) standard. CONCLUSION: Wide-awake technique applied in flexor tendon tenolysis can accurately judge the tendon adhesion and release degree through the patient's active activity, achieve the purpose of complete release, and the effectiveness is satisfactory; the effectiveness of tendon adhesion release surgery after fracture internal fixation is better than that of patients after tendon rupture suture and replantation.

Ginsenoside Rg1 promotes proliferation and neurotrophin expression of olfactory ensheathing cells.

Transplantation of olfactory ensheathing cells (OECs) is currently considered to be one of the most promising repair strategies for human spinal cord injury. However, the factors that regulate OECs are still poorly understood. Ginsenoside Rg1 (Rg1), the phytosterol from Panax ginseng, is a potent neuroprotective agent that promotes axonal regeneration. The aim of this study is to determine whether Rg1 would influence the biological activity of OECs. Primary cultured OECs from the olfactory bulb of neonatal rats were treated with Rg1 of various concentrations and durations. Using MTT and bromodeoxyuridine assays, we found that Rg1 significantly promoted cell proliferation, with an optimal concentration of 40 mug/ml of Rg1 at 72 h. In addition, RT-PCR and ELISA assays showed that Rg1 could upregulate the mRNA expression and secretion of glial cell-derived neurotrophic factor, brain-derived neurotrophic factor, and nerve growth factor. These results suggest that Rg1 may have a great potential in OEC therapy.