Advancing treatment strategies for posterior malleolar malunion: The ankle dislocation method.

BACKGROUND: This study aimed to assess the radiological and clinical outcomes of treatment using the ankle dislocation method for posterior malleolar malunion. METHOD: Thirty-one patients with posterior malleolar malunion who underwent treatment using the ankle dislocation method from May 2015 to October 2021 were retrospectively analyzed. Key outcome measures were radiographic parameters (articular step-off, tibiofibular clear space, fibular length, tibial lateral surface angle, and ankle osteoarthritis), clinical scores (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale and Visual Analogue Scale), and patient satisfaction rate. RESULT: Preoperative computed tomography revealed that Bartoní cek types 3 and 4 accounted for 64.5 % (n = 20) of total cases. Most posterior malleolar malunions were accompanied by depressed intercalary fragments (61.2 % [n = 19]). At the final follow-up, radiographic parameters and clinical scores showed significant improvements postoperatively (P < 0.05), with a high patient satisfaction rate of 77.4 %. Subgroup analysis revealed that the posterior malleolar fracture morphology significantly affected postoperative pain, particularly in more complex fractures (P < 0.001). CONCLUSION: The ankle dislocation method effectively exposes the distal tibial articular surface and facilitates the anatomical restoration of joint congruity under direct vision. This approach substantially improves the clinical and imaging outcomes in patients with complex posterior malleolar malunion. LEVELS OF EVIDENCE: Level IV, retrospective case series.

[Comparison of efficacy of platelet-rich plasma and extracorporeal shock wave for the treatment of chronic insertional Achilles tendinopathy].

OBJECTIVE: To compare clinical efficacy of platelet-rich plasma (PRP) and extracorporeal shock wave in treating chronic insertional Achilles tendinopathy. METHODS: From February 2019 to August 2021, 42 patients with chronic insertional Achilles tendinopathy were selected and divided into PRP group(20 patients, 28 feet) and shock wave group (22 patients, 29 feet). In PRP group, there were 12 males and 8 females, aged 47.00(28.00, 50.75) years old, and the courses of disease ranged 7.00(6.00, 7.00) months;PRP injection was performed in the Achilles tendon stop area of the affected side. In shock wave group, there were 16 males and 6 females, aged 42.00(35.75, 47.25) years old;and the courses of disease was 7.00(6.00, 8.00) months;shock wave was performed in Achilles tendon stop area of the affected side and triceps surae area. Visual analogue scale (VAS) and Victorian Institute of Sport Assessment-Achilles (VISA-A) were applied to evaluate clnical effect before treatment, 1, 3 and 6 months after treatment, and satisfaction of patients was investigated. RESULTS: VAS and VISA-A score in both groups were significantly improved at 1, 3 and 6 months after treatment than before treatment (P<0.05), VAS and VISA-A score in PRP group at 6 months after treatment were significantly higher than those at 1 and 3 months after treatment, and VAS and VISA-A score in shock wave group were lower than those at 1 and 3 months after treatment (P<0.05). There was no significant difference in VAS and VISA-A score between two groups before treatment, 1 and 3 months after treatment(P>0.05), while VAS and VISA-A score in PRP group were better than those in shock wave group at 6 months after treatment(P<0.05), and the satisfaction survey in PRP group was better than that in shock wave group(P<0.05). CONCLUSION: PRP injection has a good clinical effect on chronic insertional Achilles tendinopathy with high patient satisfaction, and medium-and long-term effect of PRP injection for the treatment of chronic insertional Achilles tendinopathy is better than that of extracorporeal divergent shock wave.

Microwave-assisted alkali hydrolysis for cellulose isolation from wheat straw: Influence of reaction conditions and non-thermal effects of microwave.

Microwave-assisted hydrolysis has been widely studied for cellulose fiber isolation, but the influence of reaction conditions and the microwave non-thermal effect are not well clarified. In this study, a series of well-designed experiments were carried out to measure the effects of reaction conditions including temperature, duration and alkali concentration. Compared to the other parameters, temperature was more relevant to the cellulose content in fiber. It could reach the maximum purity of 90.66 % when the temperature was up to 140 °C. Moreover, the existence of non-thermal effect of microwave has been confirmed through extensive determination and characterization of the fibers obtained from parallel controlled experiments conducted with or without microwave assistance. Approximately 50 %-75 % reduction in reaction time or 67 % of that in chemical costs would be realized under microwave with respect to traditional heating hydrolysis. Therefore, this work provides both deep insight and efficiency strategy into the microwave-assisted cellulose isolation.

[VSD technique combined with Bing Shi Yu Shang Ointment for the treatment of foot skin defects].

OBJECTIVE: To explore the clinical effect of vacuum sealing drainage (VSD) technique and Bing Shi Yu Shang Ointment in the treatment of foot skin defect. METHODS: From November 2017 to April 2019, 21 patients (21 feet) with foot skin defect were treated with VSD technique and Bing Shi Yu Shang Ointment. There were 17 males and 4 females, aged from 24 to 60 years old with an average of (37.8±11.2) years, 9 cases caused by traffic accident injury, 6 cases by heavy injury, 6 cases by falling injury. The time from injury to operation was for 3 to 36 (8.6±7.2) h, and the area of foot skin defect was for 20.35 to 83.43(47.2±19.5) cm2. All patients underwent debridement or phaseⅠtemporary fixation in emergency, and three-dimensional imagingof the foot was performed by using Mimics software, and the defect area was rendered. The quality of wound healing and complications were observed, and the clinical effect was evaluated by Maryland foot function score. RESULTS: All the 21 patients were followed up for 7 to 17 (10.8±2.7) months. There was no infection or nonunion in all patients. At the final follow-up, the skin margin of the healing site grew tightly, the skin was elastic, the texture was tough, the appearance was no obvious carbuncle. The time of wound healing was for 18 to 63 (41.2±13.3) days. Eight patients underwent stageⅡfixation or/and fusion, and all incisions healed by stageⅠ. According to Maryland's foot scoring, 9 cases got excellent results, 11 good, and 1 middle. CONCLUSION: VSD can effectively remove the necrotic tissue of the wound, provide a smooth drainage of the wound, combine with Bing Shi Yu Shang Ointment to prevent infection and promote the rapid growth of granulation tissue, whose whole treatment cycle was short, the wound healing site was highquality, the limb function was good, and the clinical effect was satisfactory.

[Effects of plant polysaccharide compound agents on the photosynthetic characteristics and dry matter of soybean].

A field experiment was conducted to study the effects of foliar spraying three compound agents [plant polysaccharides (P1), plant polysaccharides and 5-aminolevulinic acid (P2), and plant polysaccharides and 5-aminolevulinic acid and dimethylpiperidinium chloride (P3)] at the initial flowering stage of soybean on its leaf chlorophyll content, photosynthesis and transpiration, dry matter accumulation and allocation, and grain yield. Within 35 days after spraying the three compound agents, the leaf chlorophyll content had obvious increase, and its decreasing trend with plant growth had somewhat delay. Compared with the control, spraying P1 and P3 increased the leaf photosynthetic rate and water use efficiency by more than 13.2% and 10.3%, respectively. With the spraying of the three compound agents, the dry matter accumulation in aerial part increased, and the allocation of dry matter from leaf to pod was also enhanced, with the contribution of post-anthesis assimilates to grain yield increased by more than 17.1%. The 100-grain mass and the pods and seeds per plant increased significantly after spraying P1 and P3, but had no significant increase after spraying P2. The grain yield of soybean treated with the three compound agents increased by more than 5.9%, compared with the control. This study showed that the three plant polysaccharide compound agents could increase the leaf chlorophyll content, delay the leaf-senescence, improve the leaf photosynthetic capacity and water status, effectively control the dry matter accumulation and post-anthesis assimilates allocation, and increase the grain yield of soybean.