[Application of improved carpal shoot through view in volar plate internal fixation of distal radius fractures].

Objective: To explore the application of improved carpal shoot through view (ICSTV) method in the treatment of distal radius fractures with volar plate internal fixation. Methods: The clinical data of 67 patients with distal radius fractures who met the selection criteria between January 2020 and January 2023 was retrospectively analyzed. There were 30 males and 37 females with an average age of 53.6 years (range, 18-75 years). According to the AO/Orthopaedic Trauma Association (AO/OTA) classification, there were 25 cases of type B and 42 cases of type C. The time from injury to operation ranged from 2 to 6 days, with an average of 3.8 days. During the operation, bilateral cortical drilling was performed, and the length of the implanted screw was 1-2 mm shorter than that measured by the depth ruler. Standard anteroposterior and lateral (AAL) fluoroscopy and ICSTV fluoroscopy were performed after volar anatomic locking plate fixation, respectively. If the dorsal cortex of the distal radius was detected to be penetrated, the short screw was replaced and ICSTV fluoroscopy was performed again until no screw was penetrated. The detection rate of dorsal cortical screw penetration was compared between AAL fluoroscopy and ICSTV fluoroscopy. Postoperative CT scan was performed to confirm the presence or absence of dorsal cortical screw penetration. Results: Intraoperative AAL fluoroscopy found 5 screws penetrating the dorsal cortex in 4 patients (6.0%), and ICSTV fluoroscopy found 19 screws penetrating the dorsal cortex in 15 patients (22.4%) including the above 4 patients, with a significant difference in the detection rate between the two fluoroscopy methods [ OR=0.267 (0.084, 0.845), P=0.018]; 15 patients were replaced with short screws during operation. At the same time, ICSTV fluoroscopy detected 2 screws penetrating into the distal radioulnar joint in 2 cases (3.0%), which could not be found in AAL fluoroscopy, and the direction of the screws was adjusted and replaced. All patients were reexamined by wrist CT within 3 days after operation, and no dorsal cortical screw penetration or screw penetration into the distal radioulnar joint was found. All the 67 patients were followed up 6-18 months, with an average of 11.3 months. Extensor tendon irritation occurred in 2 patients at 3 months after operation, and no extensor tendon rupture occurred in all patients during follow-up. All fractures healed well, and the healing time was 8-13 weeks, with an average of 10.8 weeks. There was no complication such as internal fixation loosening or fracture displacement. The Gartland-Werley score at last follow-up ranged from 0 to 15, with an average of 5.6. Conclusion: ICSTV fluoroscopy can effectively detect occult dorsal cortical screw penetration of the distal radius that can not be revealed by AAL fluoroscopy.

Mannose enhances intestinal immune barrier function and dextran sulfate sodium salt-induced colitis in mice by regulating intestinal microbiota.

Background: Inflammatory bowel disease (IBD) greatly affects human quality of life. Mannose has been reported to be used to treat IBD, but the mechanism is currently unknown. Methods: C57/BL mice were used as research subjects, and the mouse acute colitis model was induced using dextran sulfate sodium salt (DSS). After oral administration of mannose, the body weights and disease activity index (DAI) scores of the mice were observed. The colon lengths, histopathological sections, fecal content microbial sequencing, colon epithelial inflammatory genes, and tight junction protein Occludin-1 expression levels were measured. We further used the feces of mice that had been orally administered mannose to perform fecal bacterial transplantation on the mice with DSS-induced colitis and detected the colitis-related indicators. Results: Oral administration of mannose increased body weights and colon lengths and reduced DAI scores in mice with DSS-induced colitis. In addition, it reduced the expression of colon inflammatory genes and the levels of serum inflammatory factors (TNF-α, IL-6, and IL-1ß), further enhancing the expression level of the colonic Occludin-1 protein and alleviating the toxic response of DSS to the intestinal epithelium of the mice. In addition, gut microbial sequencing revealed that mannose increased the abundance and diversity of intestinal flora. Additionally, after using the feces of the mannose-treated mice to perform fecal bacterial transplantation on the mice with DSS-induced colitis, they showed the same phenotype as the mannose-treated mice, and both of them alleviated the intestinal toxic reaction induced by the DSS. It also reduced the expression of intestinal inflammatory genes (TNF-α, IL-6, and IL-1ß) and enhanced the expression level of the colonic Occludin-1 protein. Conclusion: Mannose can treat DSS-induced colitis in mice, possibly by regulating intestinal microorganisms to enhance the intestinal immune barrier function and reduce the intestinal inflammatory response.