[Comparison of therapeutic effects of arthroscopic popliteal cyst internal drainage and capsular wall resection].

OBJECTIVE: To investigate efficacy between arthroscopic popliteal cyst drainage and arthroscopic popliteal cyst resection. METHODS: From January 2013 to June 2021, 54 patients with popliteal cyst (Rausching-Lindgren gradeⅠto Ⅲ) were treated with arthroscopic surgery. There were 24 males and 30 females. The age ranged from 44 to 72 years old, with a mean of (62.67±6.08) years old. The course of the disease ranged from 1 to 72 months, with a mean of(15±14) months. Twenty-four patients (group A) were underwent arthroscopic internal drainage of popliteal cyst. Thirty patients (group B) were underwent arthroscopic resection of popliteal cyst. Preoperative main symptoms included knee pain, swelling, walking pain, popliteal swelling, popliteal mass and so on. After 1, 3, 6 months and 1, 2 years of surgery, routine outpatient follow-up was conducted to observe and compare the surgical time, bleeding volume, preoperative and postoperative visual analog scale (VAS), knee Lysholm score, and complications between two groups. RESULTS: All incisions healed at one stage after operation. All 54 patients were followed up, and the duration ranged from 6 months to 2 years, with an average of (13.89±4.29) months. There was no intraoperative vascular or nerve injury. Operation time and intraoperative blood loss of the two groups:group A of (62.08±9.55) min and (8.00±1.69) ml, group B of (69.50±6.99) min and (8.70±2.00) ml. Popliteal pain, swelling, limitation of flexion and extension were significantly relieved after operation. VAS before and one month after operation between two groups:group A of 5.38±1.21 and 2.63±0.71, group B of 5.60±1.26 and 2.80±0.81. Lysholm scores of knee joint before and 6 months after operation:group A of 62.59±4.99 and 89.74±2.90, group B of 63.87±3.23 and 89.02±2.35. Knee joint function improved significantly in both groups. In group A, 4 cases had popliteal cyst at 3 months after operation, and 2 cases had small isolated cyst at 1 year after operation. There was no recurrence of cyst in group B. CONCLUSION: The results between two arthroscopic treatments of popliteal cyst are satisfactory, and there is no significant difference in the amount of blood loss, safety, postoperative pain VAS score and knee function recovery. It is suggested that arthroscopic resection of the cyst wall should be performed when the technique is mature, especially for large cysts and septal cysts.

Chiral amino acid modified boron-dipyrromethene nanoparticles with different photodynamic activities.

Amino acids are one kind of basic life unit in biological systems. Modification with amino acids may bring interesting properties to the principal molecules. In this work, BDP was modified with L-aspartic acid (Asp) and D-Asp to obtain BDP-LAsp and BDP-DAsp, respectively. The as-synthesized BDPs can self-assemble into uniform nanoparticles (NPs) due to the hydrophilicity of Asp. We found that BDP-LAsp NPs possessed higher photodynamic therapeutic efficacy than BDP-DAsp NPs in fighting against cancer cells and bacteria. This provides a simple design strategy for the modification of photosensitizers in the biomedical field.

Toluene degradation in air/H2O DBD plasma: A reaction mechanism investigation based on detailed kinetic modeling and emission spectrum analysis.

Non-thermal plasma (NTP) is emerging as an attractive method for decomposing volatile organic compounds (VOCs). In this paper, to study toluene degradation mechanism in air/H2O dielectric barrier discharge (DBD) plasma, optical emission spectrometry (OES) was employed to in-situ monitor active species in plasma, with the permanent degradation products being detected by on-line mass spectrometry under various operations. A detailed kinetic model of NTP with incorporation of non-constant electron filed and thermal effects has also been established. A toluene degradation efficiency > 82% could be achieved at P = 115 W, Cin, toluene = 1000 ppm. The relative spectrum intensity of excited OH, O, H and N2 (A3Σ+u) increased with increase of discharge power and was decreased at higher gas flowrates. Toluene degradation was mainly induced by oxidation of OH and O at afterglow stage, while part of toluene was decomposed by attack of electrons and reactive particles N2 (A3Σ+u) in discharge stage. A toluene degradation pathway has been proposed as: toluene→benzyl→benzaldehyde→benzene→phenoxy→cyclopentadiene→polycarbenes/alkynol→CO2/H2O. Benzoquinone, benzaldehyde, cyclopentadiene and cyclopentadienyl are supposed to be important intermediates for the ring-opening of toluene. Clarification of toluene degradation behaviors at discharge and afterglowing stage could provide new insights for plasma-catalytic process in future.

[Locking compression plate combined with medial buttress plate for the treatment of osteoporotic comminuted proximal humerus fractures].

OBJECTIVE: To explore clinical effect of lateral locking compression plate combined with medial buttress plate in treating osteoporotic comminuted fractures of proximal humerus. METHODS: From May 2017 to December 2021, 12 patients with osteoporotic comminution of proximal humerus were treated by lateral locking compression plates combined with medial buttress plates, including 5 males and 7 females, aged from 55 to 78 years old, bone mineral density(BMD) less than -2.5 g/cm3, the time from injury to operation was from 2 to 6 days. According to Neer classification, 7 patients were type Ⅲ, 4 patients were type Ⅳ and 1 patient was type Ⅵ. Postoperative complications, fracture healing and internal fixation were observed and Constant-Murley score of shoulder joint was used to evaluate clinical effects at 6 months after operation. RESULTS: Postoperative wound healed well at stage I. All patients were followed up from 6 to 18 months. Humeral head collapse and necrosis occurred in 1 patient and humeral head varus in 1 patient. No impact of shoulder joint, internal fixation loosening occurred. Constant-Murley score at 6 months ranged from 45 to 90 points, and 6 patients got excellent result, 3 good, and 3 poor. CONCLUSION: Locking compression plate combined with medial buttress plate could effectively reconstruct medial humeral column support and enhance fracture stability, and receive satisfactory clinical results. However, no control group was established in this study, and function of shoulder joint has not been evaluated many times after operation, so it cannot dynamically reflect changes of shoulder joint function.

Diagnosis and Treatment of Intraosseous Ganglion in the Ankle Region.

OBJECTIVE: To investigate the diagnosis and treatment of intraosseous ganglion cyst in the ankle region. METHODS: A retrospective analysis was performed on the diagnosis and treatment of 18 patients with intraosseous ganglion in the ankle region from January 2005 to March 2016. There were 11 males and 7 females, with an average age of 40.4 years (22-74 years). Thirteen of these had mild intermittent localized pain in the ankle and five were asymptomatic and fortuitously found on images. According to the location of the intraosseous ganglion cyst, nine were located in the distal end of tibia, seven were in the distal end of the fibula, and two were in the talus. After curettage of intraosseous ganglion, 15 cases were filled with autogenous iliac bone and 3 cases with artificial bone. RESULTS: Fifteen cases were diagnosed with radiographs and CT scans, two cases with MR images, and one case was confirmed by postoperative pathology. The cyst contents were jelly-like material with sclerotic bone margins. The mean size of the intraosseous ganglion cyst was 1.5 cm × 1.5 cm × 1 cm. Hematoxylin and eosin (H&E) staining of the tissue showed fibrous tissue, collagenous fiber, mucoid, and a few fibroblasts. Eighteen cases were followed up for 11 months to 10 years, with an average of 5.4 years. No recurrence was found. Sixteen patients were asymptomatic after surgery. Two cases of ankle pain occurred at 1 year and 6 months postoperatively, respectively. According to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, the mean AOFAS ankle-hindfoot score improved from 78.2 ± 13.7 points preoperatively to 97.3 ± 4.5 points at the final follow-up. CONCLUSION: For the intraosseous ganglion cyst in the ankle region, whether there are clinical symptoms or not, the cyst should be curettaged and the cavity should be filled with bone graft. The operation result is satisfactory.

[Cannulated screw internal fixation for sustentaculum tali fractures with articular surface].

OBJECTIVE: To explore clinical efficacy of cannulated screw internal fixation in treating sustentaculum tali fractures with articular surface. METHODS: From August 2012 to June 2017, 13 sustentaculum tali fracture patients with articular surface were treated by cannulated screw internal fixation, including 10 males and 3 females, aged from 26 to 58 years old. Joint plane flatness was evaluated by calcaneal width, clearance distance of middle-range and posterior talar articular surface on coronal position of CT scan before operation and 1 year after operation. AOFAS score at 1 year after operation was applied to evaluate clinical efficacy. RESULTS: All patients were followed up from 9 to 70 months. The fractures were healed well from 8 to 16 weeks. No subtalar arthritis and tenosynovitis occurred. Calcaneal width before operation was from 46.2 to 52.7 mm, and decreased from 35.2 to 39.2 mm after operation; clearance distance of middle-range before operation was from 4.5 to 4.8 mm, and decreased from 1.9 to 2.2 mm after operation; clearance distance of posterior talar articular surface before operation was from 2.4 to 2.8 before operation, and decreased from 1.9 to 2.3 mm after operation. AOFAS score at 1 year after operation ranged from 77 to 94, and 1 got excellent result and 12 moderate. CONCLUSIONS: The clinical efficacy of two cannulated screws with cross internal fixation for sustentaculum tali fractures with articular surface is satisfactory, sustentaculum tali fracture could obtain good reduction, recover smooth of middle talar articular surface, and the function of feet were improved.

[Modified osteotomy of olecranon for the management of inter-condylar fracture of the humerus].

OBJECTIVE: To explore the surgical method and clinical outcome of modified osteotomy of olecranon for the treatment of inter-condylar fracture of humerus. METHODS: From May 2007 to December 2012, 32 patients of intercondylar fracture of humerus were treated surgically through the approach of modified osteotomy of olecranon. The patients were 21 males and 11 females with a mean age of 46.3 years (ranged 18 to 65 years). Nineteen fractures occurred on the right extremity and 13 on the left extremity. According to the AO classification, type C1 fracture was found in 7, C2 in 11 and C3 in 14. Five patients suffered from open fracture (Gustilo type Iin 3, type II in 2). Other fractures occurred in 6 patients and the primary injury of nerve occurred 6. The healing of the osteotomy was evaluated with physical examination and plain X-ray film, and the function of elbow was assessed according to Cassebaum scale. RESULTS: All the patients were followed from 9 months to 5 years(average, 1.9 years). All the osteotomies healed at 7.4 weeks averagely after operation, and no nonunion, delayed union, fracture of ulna olecranon were found. Two cases had little pain on the elbow, heterotopic ossification occurred in 2 cases and cutting bone block loosed in 1 case. The function of the elbow showed excellent in 19 cases, good in 8, fair in 4 and poor in 1. CONCLUSIONS: The use of the approach of modified olecranon osteotomy for surgical management of intercondylar fracture of humerus has some advantages, it provides satisfactory stability with simple technical procedures avoiding inter-articular invasion, and it facilitates rehabilitation exercises and providing good results with low complication rates.

[Modified Stoppa approach in treatment of bilateral pubic branch fractures].

OBJECTIVE: To investigate the feasibility and effectiveness of modified Stoppa approach in treatment of bilateral pubic fractures of pelvic. METHODS: The therapeutic effects of 16 patients with bilateral pubic fractures treated through the modified Stoppa approach from January 2010 to January 2014 were summarized and analyzed, involved 11 males and 5 females with an average age of 40.5 years old ranging from 17 to 59 years. According to Tile classification, there were 8 patients with type A, 6 with type B and 2 with type C. For 16 pelvic fractures, the modified Stoppa approach was used exclusively 11 cases, in combination with the iliac fossa approach in 4 cases, and in combination with the posterior approach in 1 case. The operation incision length, operation time , intra-operative blood loss and postoperative complications were observed. The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively. RESULTS: The incision length of the modified Stoppa approach ranged from 8 to 10 cm (averaged in 9 cm). The operation time ranged from 75 to 135 minutes (averaged in 95 minutes). The intra-operative blood loss ranged from 400 to 900 ml (averaged in 600 ml). Sixteen patients were followed up from 7 to 18 months (averaged in 12.5 months). The fractures were all healed, the fracture healing time was 2.7 to 5 months (means 3.1 months). There were no infections, ectopic ossification, screw loosening, plate breakage and lateral ventral syndrome. According to Matta criteria for pubic fracture reduction, the result was excellent in 9 cases, good in 6, fair in 1. The Majeed function scores at 6 months after operation was 85.32±8.50; the result was excellent in 8 cases, good in 6 cases, fair in 2 cases. CONCLUSION: The modified Stoppa approach has characteristics of convenience and directness of incisions, clear operation field, easy reduction, few complications and fast recovery , it is an ideal choice in surgical treatment of bilateral pubic fractures.

[Reversed sural neurovascular fasciocutaneous flap for reconstruction of soft tissue defects of lower limbs].

OBJECTIVE: To investigate the clinical application of the reversed sural neurovascular fasciocutaneous flap. METHODS: From January 2007 to May 2009,10 patients (6 males and 4 females) with soft tissue defects on lower limbs were treated by reversed sural neurovascular fasciocutaneous flap. The end-to-side neuroanastomosis were used to reinnervate the flap and microsurgery was used for anastomosing small saphenous vein. The age ranged from 16 to 55 years (mean, 32 years). There were 6 patient with soft tissue defects on foot, 2 patients with exposed bone after operation, 2 patients with chronic ulcer on limb. The patients were evaluated with appearance, blood supply, texture and 2-PD of the flaps. RESULTS: All the patients were followed for 6 to 24 months (mean, 15 months). The flaps in all 10 patients survived completely. The appearance, blood supply and texture of the flaps were excellent and 2-PD was 9 to 12 mm. CONCLUSION: This flap has sufficient blood supply and high survival rate. It also effectively retains the feeling of dorsolateral heeland improved quality of life.

[Surgical treatment of tibia plateau fractures with external fixator and the locking plate].

OBJECTIVE: To observe the clinical effect of the treatment for complex fractures of the tibial plateau through the application of the external fixator and the locking plate. METHODS: From Feb. 2006 to Oct. 2008,12 patients with tibial plateau fractures were treated with external fixator and locking plate included 8 males and 4 females with an average age of 38 years ranging from 23 to 59. According to Schatzker type, 7 cases were type V and 5 cases were type VI. Using an anteromedial incision and an anterolateral approach, the locking plate were fixed in the tibia lateral. The collapse and height lossing of tibial plateau was observed through X-ray film before and after operation. The function of knee joint was evaluated according to HSS scoring. RESULTS: These patients were followed up for 4 to 18 months (means 9.79 months). Eleven cases had bone primary union,and 1 delayed union. No deep phlebothrombosis and osteofascial compartment syndrome occurened. The average healing time was 3.1 months. Between the preoperative and postoperative X-ray film there were no second stage depression fracture of the tibial plateau,postoperative reduction loss and bad alignment. The range of knee flexion was 90 degrees to 110 degrees. The HSS knee functional scoring was(75.50 +/- 10.01)scores after operation and (21.50 +/- 11.68) scores before operation. CONCLUSION: The treatment with the external fixator and the locking plate for complex fractures of the tibial plateau could provid continuous stability of fixation,prevent the fracture from second stage displacement and the knee force line change, protect the soft-tissue around the knee, reduce the postoperative complications. The knee joint function is satisfied.

[Diagnosis and treatment of the coronal fracture of the femoral condyle].

OBJECTIVE: To investigate the diagnosis and treatment of the coronal fracture of the femoral condyle. METHODS: Seven patients with Hoffa fracture treated in our hospital in recent 7 years were enrolled in this study. Six patients were treated with surgical treatment, while one non-displaced fracture received conservative treatment. Fractures were reduced under direct vision and fixed with hollow lag screws. The knees were immobilized in extension with cast after operation, and flexion exercise was commenced 3 weeks later. RESULTS: All the patients were followed up. According to Kumar functional assessment system,5 patients got excellent results, 1 good, and 1 fair. CONCLUSION: Rigid internal fixation with hollow lag screw and extension plaster fixation is the excellent way to treat the coronal fracture of the femoral condyle.