Is traumatic meniscal lesion associated with acute fracture morphology changes of tibia plateau? A series of arthroscopic analysis of 67 patients.

BACKGROUND: Computed tomography (CT) has become a routine preoperative examination for tibial plateau fractures (TPFs). Assessing the location of the fragment and intercondylar eminence fracture can provide clinicians with valuable information; however, the evaluation of traumatic meniscal lesion (TML) and arthroscopic management are controversial. AIM: To predict TML by three-dimensional skeletal anatomy changes in unilateral TPF and bilateral TPF on preoperative thin layer CT. METHODS: Acute fracture of tibial plateau patients undergoing arthroscopic surgery between December 2017 and December 2019 were included in this retrospective study. The type, zone, and location of TMLs were diagnosed based on the operation records and/or arthroscopic videos. Measurement of three-dimensional fracture morphology included the following: Frontal fragment width of plateau, sagittal fragment subsiding distance (FSD), sagittal fracture line distance, sagittal posterior tibial slope, and transversal area ratio of fragment area) on preoperative CT three-dimensional plane. The correlation of TML with skeletal values was calculated according to unicondylar TPFs and bicondylar TPFs. RESULTS: A total of 67 patients were enrolled in this study, among which 30 patients had TMLs, lateral/medial (23/7). FSD was a particularly positive factor to predict TML, with odds ratio of 2.31 (1.26-5.63). On sagittal view of CT, FSD degree of 8 mm and posterior tibial slope exceeding 11.74° implied enhanced risk of TML in bicondylar TPFs. On coronal view, once fragment width of plateau surpassed 3 cm, incidence of TML reached 100%. On transverse view, area ratio of fragment as enhanced risk of 5.5% and FSD > 4.3 mm for predicting TML were observed in unicondylar TPFs. CONCLUSION: TML can be predicted by different parameters on preoperative CT views according to unicondylar fractures and bicondylar TPFs.

A new Himalayan species of Alfieriella (Coleoptera: Cryptophagidae).

A new species of Alfieriella Wittmer, 1935 (Coleoptera, Cryptophagidae), Alfieriella senguptai sp. n. from China and India, is described. This is the first formal record of the genus Alfieriella and the tribe Hypocoprini from the Himalayan region. Alfieriella senguptai is the largest member of Alfieriella, and its presence in a cold, high-altitude environment conforms to Bergmann's rule. The distribution of the genus Alfieriella may be associated with the breakup of the Tethys Ocean and the origin of A. senguptai influenced by the Himalayan orogeny. A distribution map and a key to species of Alfieriella are also provided.

[Safety and efficacy of firebird drug-eluting stent combination tirofiban in patients with acute coronary syndrome].

OBJECTIVE: To evaluate the safety and efficacy of Firebird drug-eluting stent (DES) combining Tirofiban and Cypher DES combining Tirofiban in patients with acute coronary syndrome (ACS). METHODS: 323 ACS patients were divided into 2 general conditions-matched groups: Firebird group (n = 161) undergoing Firebird DES implantation and Tirofiban intravenous injection 10 microg x kg(-1) within 3 minutes followed by Tirofiban 0.15 microg x kg(-1) x min(-1) intravenous maintenance infusion with micro pump for 36 hours, and Cypher group (n = 162) undergoing Cypher DES implantation and Tirofiban. The safety was observed instantly and 36 h after the implantation. The patients were followed up for 30 d. Some patients in the Firebird group underwent coronary angiography and intravascular ultrasound because of angina and part of target vessels underwent revascularization. RESULTS: There were no significant differences between the 2 groups in ejection fraction target coronary lesion type, blood platelet count, HB and HCT before treatment. The success rates of operation were both 100% in these 2 groups. No complication occurred in both groups. There were not significant differences in the blood platelet count, hemoglobin, hematocrit, acute stent thrombosis rate (1.2% vs 1.2%), acute myocardial infarction rate (1.3% vs 1.3%), target vessel revascularization rate (0.6% vs 1.3%), and rehospitalization rate (1.3% vs 0.7%) (all P > 0.05). 30 d no in-stent restenosis was found by angiographic and intravascular ultrasound follow-up in the Firebird group. CONCLUSION: Firebird DES combining Tirofiban and Cypher DES combining Tirofiban are both safe and effective in treating ACS.

[The efficacy of percutaneous coronary intervention combined percutaneous thrombectomy on coronary thrombotic lesions in patients with acute myocardial infarction].

OBJECTIVE: To evaluate the efficacy of percutaneous coronary intervention (PCI) combined percutaneous thrombectomy on coronary thrombotic lesions in patients with acute myocardial infarction (AMI). METHODS: PCI were performed in 56 patients with AMI and positive coronary thrombus shown by angiography and these patients were randomly divided into PCI therapy group (n = 28) and PCI combined percutaneous thrombectomy group (n = 28). Real-time myocardial contrast echocardiography (RT-MCE) was performed at 24h and 1 week after PCI. Contrast score index (CSI), regional wall motion score index (WMSI), endocardial length of contrast defect (CDL), and wall motion abnormality (WML) were calculated. The plasma level of hs-CRP was measured by immunonephelometry. The plasma concentration of N-terminal proB-type natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9) were detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: CSI, WMSI, CDL and WML at 24 hours and 1 week post procedure as well as the levels of hs-CPR and NT-proBNP at 1 week post procedure [(4.56 +/- 1.98) mg/L vs. (5.96 +/- 2.03) mg/L, P < 0.05; (544.7 +/- 185.3) pmol/L vs. (897.6 +/- 215.9) pmol/L, P < 0.01] were significantly lower in PCI combined percutaneous thrombectomy group than those in PCI group in various time points. There were no differences in the plasma level of MMP-9 between the two groups [(672.7 +/- 175.9) microg/L vs. (609.6 +/- 196.5) microg/L, P > 0.05] at 1 week after PCI. CONCLUSIONS: PCI combined percutaneous thrombectomy can significantly reduce no-reflow phenomenon, improve microcirculation and myocardial dysfunction. Thus PCI combined percutaneous thrombectomy is a feasible therapy in patients with AMI.