Pub Date : 2024-11-15DOI: 10.7507/1002-1892.202404099
Xiuzhen Zhang, Jiawei Wang, Huiqi Xie
Objective: To summarize the research progress of bio-derived materials used for bladder regeneration and repair.
Methods: The recent domestic and foreign sutudies on bio-derived materials used for bladder regeneration and repair, including classification, morphology optimization process, tissue regeneration strategies, and relevant clinical trials, were summarized and analyzed.
Results: Numerous types of bio-derived materials are employed in bladder regeneration and repair, characterized by their low immunogenicity and high inducible activity. Surface modification, gelation, and other morphology optimization process have significantly broadened the application scope of bio-derived materials. These advancements have effectively addressed complications, such as perforation and urolith formation, that may arise during bladder regeneration and repair. The strategy of tissue regeneration utilizing bio-derived materials, targeting the regeneration of bladder epithelium, smooth muscle, blood vessels, and nerves, offers a novel approach to achieving functional regeneration of bladder. Bio-derived materials show great promise for use in bladder regeneration and repair, yet the results from clinical trials with these materials have been less than satisfactory.
Conclusion: Bio-derived materials are widely used in bladder regeneration and repair due to the good biocompatibility, low immunogenicity, and degradable properties, yet face a series of problems, and there are no commercialized bladder tissue engineering grafts used in clinical treatment.
{"title":"[Application and progress of bio-derived materials in bladder regeneration and repair].","authors":"Xiuzhen Zhang, Jiawei Wang, Huiqi Xie","doi":"10.7507/1002-1892.202404099","DOIUrl":"10.7507/1002-1892.202404099","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the research progress of bio-derived materials used for bladder regeneration and repair.</p><p><strong>Methods: </strong>The recent domestic and foreign sutudies on bio-derived materials used for bladder regeneration and repair, including classification, morphology optimization process, tissue regeneration strategies, and relevant clinical trials, were summarized and analyzed.</p><p><strong>Results: </strong>Numerous types of bio-derived materials are employed in bladder regeneration and repair, characterized by their low immunogenicity and high inducible activity. Surface modification, gelation, and other morphology optimization process have significantly broadened the application scope of bio-derived materials. These advancements have effectively addressed complications, such as perforation and urolith formation, that may arise during bladder regeneration and repair. The strategy of tissue regeneration utilizing bio-derived materials, targeting the regeneration of bladder epithelium, smooth muscle, blood vessels, and nerves, offers a novel approach to achieving functional regeneration of bladder. Bio-derived materials show great promise for use in bladder regeneration and repair, yet the results from clinical trials with these materials have been less than satisfactory.</p><p><strong>Conclusion: </strong>Bio-derived materials are widely used in bladder regeneration and repair due to the good biocompatibility, low immunogenicity, and degradable properties, yet face a series of problems, and there are no commercialized bladder tissue engineering grafts used in clinical treatment.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1299-1306"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To investigate the effects of R-spondin 2 (Rspo2) on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and bone mineral content in ovariectomized mice.</p><p><strong>Methods: </strong>BMSCs were extracted from the bone marrow of the long bones of 7 4-week-old female C57BL/6 mice using whole bone marrow culture and passaged. After the cell phenotype was identified by flow cytometry, the 3rd generation cells were co-cultured with 10, 20, 40, 80, and 100 nmol/L Rspo2. Then, the cell activity and proliferative capacity were determined by cell counting kit 8 (CCK-8), and the intervention concentration of Rspo2 was screened for the subsequent experiments. The osteogenic differentiation ability of BMSCs was detected by alkaline phosphatase (ALP) staining, and the mRNA levels of osteogenesis-related genes [RUNX family transcription factor 2 (Runx2), collagen type Ⅰ alpha 1 (Col1), osteocalcin (OCN)] were detected by real-time fluorescence quantitative PCR (RT-qPCR). In addition, 18 10-week-old female C57BL/6 mice were randomly divided into sham operation group (sham group), ovariectomy group (OVX group), and OVX+Rspo2-intervention group (OVX+Rspo2 group), with 6 mice in each group. The sham group only underwent bilateral back incision and suturing, while the other two groups established osteoporosis mouse models by bilateral ovarian castration. Then, the mice were given a weekly intraperitoneal Rspo2 (1 mg/kg) treatment in OVX+Rspo2 group and saline at the same dosage in sham group and OVX group. After 12 weeks of treatment, the body mass and uterus mass of the mice were weighed in the 3 groups to assess whether the OVX model was successfully prepared; the tibia bones were stained with HE and immunohistochemistry staining to observe the changes in tibial bone mass and the expression level of Runx2 protein in the bone tissues. Blood was collected to detect the expressions of bone metabolism markers [ALP, OCN, type Ⅰ procollagen amino-terminal peptide (PINP)] and bone resorption marker [β-collagen degradation product (β-CTX)] by ELISA assay. Micro-CT was used to detect the bone microstructure changes in the tibia, and three-dimensional histomorphometric analyses were performed to analyze the trabeculae thickness (Tb.Th), trabeculae number (Tb.N), trabeculae separation (Tb.Sp), and bone volume fraction (BV/TV).</p><p><strong>Results: </strong>CCK-8 assay showed that Rspo2 concentrations below 80 nmol/L were not cytotoxic ( <i>P</i>>0.05), and the cell viability of 20 nmol/L Rspo2 group was significantly higher than that of the control group ( <i>P</i><0.05). Based on the above results, 10, 20, and 40 nmol/L Rspo2 were selected for subsequent experiments. ALP staining showed that the positive cell area of each concentration of Rspo2 group was significantly larger than that of the control group ( <i>P</i><0.05), with the highest showed in the 20 nmol/L Rspo2 group. The expression levels of the osteogen
{"title":"[Role of R-spondin 2 on osteogenic differentiation of bone marrow mesenchymal stem cells and bone metabolism in ovariectomized mice].","authors":"Xin Liu, Bowen Shi, Chengkuo Cai, Haotian Wang, Peng Jia","doi":"10.7507/1002-1892.202406083","DOIUrl":"10.7507/1002-1892.202406083","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of R-spondin 2 (Rspo2) on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and bone mineral content in ovariectomized mice.</p><p><strong>Methods: </strong>BMSCs were extracted from the bone marrow of the long bones of 7 4-week-old female C57BL/6 mice using whole bone marrow culture and passaged. After the cell phenotype was identified by flow cytometry, the 3rd generation cells were co-cultured with 10, 20, 40, 80, and 100 nmol/L Rspo2. Then, the cell activity and proliferative capacity were determined by cell counting kit 8 (CCK-8), and the intervention concentration of Rspo2 was screened for the subsequent experiments. The osteogenic differentiation ability of BMSCs was detected by alkaline phosphatase (ALP) staining, and the mRNA levels of osteogenesis-related genes [RUNX family transcription factor 2 (Runx2), collagen type Ⅰ alpha 1 (Col1), osteocalcin (OCN)] were detected by real-time fluorescence quantitative PCR (RT-qPCR). In addition, 18 10-week-old female C57BL/6 mice were randomly divided into sham operation group (sham group), ovariectomy group (OVX group), and OVX+Rspo2-intervention group (OVX+Rspo2 group), with 6 mice in each group. The sham group only underwent bilateral back incision and suturing, while the other two groups established osteoporosis mouse models by bilateral ovarian castration. Then, the mice were given a weekly intraperitoneal Rspo2 (1 mg/kg) treatment in OVX+Rspo2 group and saline at the same dosage in sham group and OVX group. After 12 weeks of treatment, the body mass and uterus mass of the mice were weighed in the 3 groups to assess whether the OVX model was successfully prepared; the tibia bones were stained with HE and immunohistochemistry staining to observe the changes in tibial bone mass and the expression level of Runx2 protein in the bone tissues. Blood was collected to detect the expressions of bone metabolism markers [ALP, OCN, type Ⅰ procollagen amino-terminal peptide (PINP)] and bone resorption marker [β-collagen degradation product (β-CTX)] by ELISA assay. Micro-CT was used to detect the bone microstructure changes in the tibia, and three-dimensional histomorphometric analyses were performed to analyze the trabeculae thickness (Tb.Th), trabeculae number (Tb.N), trabeculae separation (Tb.Sp), and bone volume fraction (BV/TV).</p><p><strong>Results: </strong>CCK-8 assay showed that Rspo2 concentrations below 80 nmol/L were not cytotoxic ( <i>P</i>>0.05), and the cell viability of 20 nmol/L Rspo2 group was significantly higher than that of the control group ( <i>P</i><0.05). Based on the above results, 10, 20, and 40 nmol/L Rspo2 were selected for subsequent experiments. ALP staining showed that the positive cell area of each concentration of Rspo2 group was significantly larger than that of the control group ( <i>P</i><0.05), with the highest showed in the 20 nmol/L Rspo2 group. The expression levels of the osteogen","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1399-1407"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the clinical diagnostic value of knee MRI at 90° flexed position for Ramp lesions of medial meniscus.
Methods: A total of 228 patients with knee pain as the main complaint who were admitted between September 2021 and September 2023 was selected as the research subjects, of which 51 patients met the selection criteria and were enrolled in the study. There were 31 males and 20 females with an average age of 38.6 years (range, 15-67 years). Body mass index was 17.2-28.7 kg/m 2 (mean, 23.9 kg/m 2). There were 25 cases of left knee and 36 cases of right knee. The time from injury to admission was 0.1-14.3 weeks (mean, 2.1 weeks). Preoperative knee MRI at fully extended position (knee extension position) and 90° flexed position (knee flexion position) were performed to determine the presence of irregular signs at the posterior edge of the medial meniscus, and PHMM fluid high signal [i.e. complete fluid filling between the posterior horn of the medial meniscus (PHMM) and the capsule margin]. Findings obtained under arthroscopy served as the "gold standard" to analyze the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of MRI at knee extension and flexion positions for the two specific signs of Ramp lesion.
Results: Twenty-one patients (41.2%) were diagnosed with Ramp lesions by using arthroscopy, including 1 case of Thaunat type Ⅰ, 2 cases of type Ⅱ, 6 cases of type Ⅲ, 7 cases of type Ⅳ, and 5 cases of type Ⅴ. The positive rates of irregular signs at the posterior edge of the medial meniscus on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( P<0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in the diagnosis of irregular signs were 76.1%, 60.0%, 66.7%, 57.1%, and 78.3% respectively at knee extension position, and 85.7%, 73.3%, 78.4%, 69.2%, and 88.0% respectively at knee flexion position. The positive rates of PHMM fluid high signal on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( P<0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in diagnosing PHMM fluid high signal were 38.1%, 100%, 74.5%, 100%, and 69.8% respectively at knee extension position, and 85.7%, 100%, 94.1%, 100%, and 90.9% respectively at knee flexion position.
Conclusion: Knee MRI at 90° flexed position improves the diagnostic performance of the detection of medial meniscal Ramp lesions compared with MRI at fully extended position.
{"title":"[Clinical diagnostic study of Ramp lesion of medial meniscus based on knee MRI at 90° flexed position].","authors":"Yuan Yao, Shujun Liu, Xianxiang Xiang, Zhiheng Wei, Weiming Wang, Jue Gong","doi":"10.7507/1002-1892.202406059","DOIUrl":"10.7507/1002-1892.202406059","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical diagnostic value of knee MRI at 90° flexed position for Ramp lesions of medial meniscus.</p><p><strong>Methods: </strong>A total of 228 patients with knee pain as the main complaint who were admitted between September 2021 and September 2023 was selected as the research subjects, of which 51 patients met the selection criteria and were enrolled in the study. There were 31 males and 20 females with an average age of 38.6 years (range, 15-67 years). Body mass index was 17.2-28.7 kg/m <sup>2</sup> (mean, 23.9 kg/m <sup>2</sup>). There were 25 cases of left knee and 36 cases of right knee. The time from injury to admission was 0.1-14.3 weeks (mean, 2.1 weeks). Preoperative knee MRI at fully extended position (knee extension position) and 90° flexed position (knee flexion position) were performed to determine the presence of irregular signs at the posterior edge of the medial meniscus, and PHMM fluid high signal [i.e. complete fluid filling between the posterior horn of the medial meniscus (PHMM) and the capsule margin]. Findings obtained under arthroscopy served as the \"gold standard\" to analyze the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of MRI at knee extension and flexion positions for the two specific signs of Ramp lesion.</p><p><strong>Results: </strong>Twenty-one patients (41.2%) were diagnosed with Ramp lesions by using arthroscopy, including 1 case of Thaunat type Ⅰ, 2 cases of type Ⅱ, 6 cases of type Ⅲ, 7 cases of type Ⅳ, and 5 cases of type Ⅴ. The positive rates of irregular signs at the posterior edge of the medial meniscus on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( <i>P</i><0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in the diagnosis of irregular signs were 76.1%, 60.0%, 66.7%, 57.1%, and 78.3% respectively at knee extension position, and 85.7%, 73.3%, 78.4%, 69.2%, and 88.0% respectively at knee flexion position. The positive rates of PHMM fluid high signal on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( <i>P</i><0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in diagnosing PHMM fluid high signal were 38.1%, 100%, 74.5%, 100%, and 69.8% respectively at knee extension position, and 85.7%, 100%, 94.1%, 100%, and 90.9% respectively at knee flexion position.</p><p><strong>Conclusion: </strong>Knee MRI at 90° flexed position improves the diagnostic performance of the detection of medial meniscal Ramp lesions compared with MRI at fully extended position.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1346-1351"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the incidence of perioperative deep venous thrombosis (DVT) of lower extremities and its risk factors in elderly patients with femoral neck fracture.
Methods: The clinical data of 4 109 elderly patients with femoral neck fracture admitted between August 2012 and November 2020 and met the selection criteria were retrospectively analyzed. Among them, there were 1 137 males and 2 972 females; their ages ranged from 65 to 101 years, with an average of 77.0 years. The time from fracture to admission ranged from 1 to 360 hours, with an average of 35.2 hours. There were 1 858 cases of hemiarthroplasty, 1 617 cases of total hip arthroplasty, and 634 cases of internal fixation surgery. The preoperative age-adjusted Charlson comorbidity index (aCCI) was 4 (3, 5). Perioperative DVT occurred in 857 cases (20.9%). Univariate analysis was performed on age, gender, body mass index, fracture side, time from fracture to admission, operation type, anesthesia type, blood transfusion, blood pressure after admission, and preoperative aCCI in patients with and without perioperative DVT, and logistic regression analysis was used to screen the risk factors of perioperative DVT in elderly patients with femoral neck fracture.
Results: Univariate analysis showed that there were significant differences in age, gender, time from fracture to admission, operation type, and preoperative aCCI between the two groups ( P<0.05). Further logistic regression analysis showed that age>75 years, female patients, time from fracture to admission>24 hours, and preoperative aCCI>5 were risk factors for perioperative DVT ( P<0.05).
Conclusion: Elderly patients with femoral neck fracture have a higher incidence of perioperative DVT. The advanced aged and female patients, patients with longer fracture time and more comorbidities need to pay special attention to the prevention of perioperative DVT to minimize the occurrence of DVT during femoral neck fractures.
{"title":"[Risk factors of perioperative deep venous thrombosis of lower extremities in elderly patients with femoral neck fracture].","authors":"Yonggang Wang, Kai Fu, Wei Zheng, Qianying Cai, Shengbao Chen, Changqing Zhang, Xianyou Zheng","doi":"10.7507/1002-1892.202403072","DOIUrl":"10.7507/1002-1892.202403072","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence of perioperative deep venous thrombosis (DVT) of lower extremities and its risk factors in elderly patients with femoral neck fracture.</p><p><strong>Methods: </strong>The clinical data of 4 109 elderly patients with femoral neck fracture admitted between August 2012 and November 2020 and met the selection criteria were retrospectively analyzed. Among them, there were 1 137 males and 2 972 females; their ages ranged from 65 to 101 years, with an average of 77.0 years. The time from fracture to admission ranged from 1 to 360 hours, with an average of 35.2 hours. There were 1 858 cases of hemiarthroplasty, 1 617 cases of total hip arthroplasty, and 634 cases of internal fixation surgery. The preoperative age-adjusted Charlson comorbidity index (aCCI) was 4 (3, 5). Perioperative DVT occurred in 857 cases (20.9%). Univariate analysis was performed on age, gender, body mass index, fracture side, time from fracture to admission, operation type, anesthesia type, blood transfusion, blood pressure after admission, and preoperative aCCI in patients with and without perioperative DVT, and logistic regression analysis was used to screen the risk factors of perioperative DVT in elderly patients with femoral neck fracture.</p><p><strong>Results: </strong>Univariate analysis showed that there were significant differences in age, gender, time from fracture to admission, operation type, and preoperative aCCI between the two groups ( <i>P</i><0.05). Further logistic regression analysis showed that age>75 years, female patients, time from fracture to admission>24 hours, and preoperative aCCI>5 were risk factors for perioperative DVT ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>Elderly patients with femoral neck fracture have a higher incidence of perioperative DVT. The advanced aged and female patients, patients with longer fracture time and more comorbidities need to pay special attention to the prevention of perioperative DVT to minimize the occurrence of DVT during femoral neck fractures.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1336-1339"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To explore early effectiveness of unilateral biportal endoscopy (UBE) technique in the treatment of migrated lumbar intervertebral disc herniation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 87 patients with migrated lumbar intervertebral disc herniation, who were treated with UBE technique between May 2021 and December 2022 and met the selection criteria. There were 55 males and 32 females, with an average age of 48.8 years (range, 29-74 years). The disease duration ranged from 2 to 23 months, with an average of 9.1 months. The surgical segments included 17 cases of L <sub>3, 4</sub>, 32 cases of L <sub>4, 5</sub>, and 38 cases of L <sub>5</sub>, S <sub>1</sub>. According to Lee's classification criteria, there were 12 cases of type 1, 17 cases of type 2, 37 cases of type 3, and 21 cases of type 4. The operation time, length of hospital stay, and complications were recorded. The visual analogue scale (VAS) score was used to assess the degree of low back and leg pain before operaion and at 3 days, 3 months, 6 months, and 12 months after operation. The Oswestry disability index (ODI) was used to evaluate the lumbar spine function. At last follow-up, the modified MacNab criteria was used to evaluate the effectiveness. According to the preoperative migrated intervertebral disc classification, the patients were allocated into groups Ⅰ to Ⅳ. The differences in VAS score and ODI were compared.</p><p><strong>Results: </strong>All 87 patients successfully completed the operations. There was no nerve root injury, dural sac injury, or dural tear during operation. The operation time was (58.6±14.6) minutes and the length of hospital stay was (4.0±0.8) days. All incisions healed by first intention after operation. No symptomatic epidural hematoma occurred. All patients were followed up for 12 months. There were significant differences in VAS scores and ODI at each time point after operation when compared with those before operation ( <i>P</i><0.05). There were significant differences in VAS score at 3 days after operation when compared with that at 3, 6, and 12 months after operation ( <i>P</i><0.05). For ODI, except that there was no significant difference between 6 and 12 months after operation ( <i>P</i>>0.05), there were significant differences between other time points after operation ( <i>P</i><0.05). At last follow-up, the effectiveness was rated as excellent in 66 cases, good in 13 cases, and fair in 8 cases according to the modified MacNab criteria, and the excellent and good rate was 90.8%. There was no intervertebral disc herniation recurred during follow-up period. There was no significant difference in VAS score and ODI among groups Ⅰ -Ⅳ before operation and at each time point after operation ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>The UBE technique is safe and effective in the treatment of migrated lumbar intervertebral disc herniation, with a low complication rate and s
{"title":"[Early effectiveness of unilateral biportal endoscopy technique for migrated lumbar intervertebral disc herniation].","authors":"Jijun Huang, Yongxiang Wang, Jiandong Yang, Xinmin Feng","doi":"10.7507/1002-1892.202408026","DOIUrl":"10.7507/1002-1892.202408026","url":null,"abstract":"<p><strong>Objective: </strong>To explore early effectiveness of unilateral biportal endoscopy (UBE) technique in the treatment of migrated lumbar intervertebral disc herniation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 87 patients with migrated lumbar intervertebral disc herniation, who were treated with UBE technique between May 2021 and December 2022 and met the selection criteria. There were 55 males and 32 females, with an average age of 48.8 years (range, 29-74 years). The disease duration ranged from 2 to 23 months, with an average of 9.1 months. The surgical segments included 17 cases of L <sub>3, 4</sub>, 32 cases of L <sub>4, 5</sub>, and 38 cases of L <sub>5</sub>, S <sub>1</sub>. According to Lee's classification criteria, there were 12 cases of type 1, 17 cases of type 2, 37 cases of type 3, and 21 cases of type 4. The operation time, length of hospital stay, and complications were recorded. The visual analogue scale (VAS) score was used to assess the degree of low back and leg pain before operaion and at 3 days, 3 months, 6 months, and 12 months after operation. The Oswestry disability index (ODI) was used to evaluate the lumbar spine function. At last follow-up, the modified MacNab criteria was used to evaluate the effectiveness. According to the preoperative migrated intervertebral disc classification, the patients were allocated into groups Ⅰ to Ⅳ. The differences in VAS score and ODI were compared.</p><p><strong>Results: </strong>All 87 patients successfully completed the operations. There was no nerve root injury, dural sac injury, or dural tear during operation. The operation time was (58.6±14.6) minutes and the length of hospital stay was (4.0±0.8) days. All incisions healed by first intention after operation. No symptomatic epidural hematoma occurred. All patients were followed up for 12 months. There were significant differences in VAS scores and ODI at each time point after operation when compared with those before operation ( <i>P</i><0.05). There were significant differences in VAS score at 3 days after operation when compared with that at 3, 6, and 12 months after operation ( <i>P</i><0.05). For ODI, except that there was no significant difference between 6 and 12 months after operation ( <i>P</i>>0.05), there were significant differences between other time points after operation ( <i>P</i><0.05). At last follow-up, the effectiveness was rated as excellent in 66 cases, good in 13 cases, and fair in 8 cases according to the modified MacNab criteria, and the excellent and good rate was 90.8%. There was no intervertebral disc herniation recurred during follow-up period. There was no significant difference in VAS score and ODI among groups Ⅰ -Ⅳ before operation and at each time point after operation ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>The UBE technique is safe and effective in the treatment of migrated lumbar intervertebral disc herniation, with a low complication rate and s","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1367-1371"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.7507/1002-1892.202406002
Heng Zhang, Xiaodong Ma, Bowen Li, Kuanxin Li, Yang Liu, Jiansheng Zhou, Jun Tao
Objective: To review research progress on the design, manufacturing, and clinical application of three-dimensional (3D) printed customized prosthesis in acetabular reconstruction of hip revision surgery.
Methods: The related research literature on 3D printed customized prosthesis and its application in acetabular reconstruction of hip revision surgery was searched by key words of "3D printed customized prosthesis", "revision hip arthroplasty", "acetabular bone defect", and "acetabular reconstruction" between January 2013 and May 2024 in Chinese and English databases, such as CNKI, Wanfang database, PubMed, etc. A total of 34 271 articles were included. After reading the literature titles, abstracts, or full texts, the literature of unrelated, repetitive, low-quality, and low evidence level was screened out, and a total of 48 articles were finally included for analysis and summary.
Results: The bone growth and mechanical properties of 3D printed customized prosthesis materials are better than those of non-3D printed customized prosthesis, which further solves the problem of elastic modulus mismatch between the implant and natural bone caused by "stress shielding"; the porous structure and antibacterial coating on the surface of 3D printed customized prosthesis have good anti-bacterial effect. 3D printed customized prosthesis can perfectly match the patient's individual acetabular anatomical characteristics and defect type, thus improving the accuracy of acetabular reconstruction and reducing the surgical time and trauma.
Conclusion: 3D printed customized prosthesis can be used for precise and efficient individualized acetabular reconstruction in hip revision surgery with good early- and mid-term effectiveness. More optimized production technics and procedures need to be developed to improve the efficiency of clinical application and long-term effectiveness.
{"title":"[Research progress of three-dimensional printed customized prosthesis and its application in acetabular reconstruction of hip revision surgery].","authors":"Heng Zhang, Xiaodong Ma, Bowen Li, Kuanxin Li, Yang Liu, Jiansheng Zhou, Jun Tao","doi":"10.7507/1002-1892.202406002","DOIUrl":"10.7507/1002-1892.202406002","url":null,"abstract":"<p><strong>Objective: </strong>To review research progress on the design, manufacturing, and clinical application of three-dimensional (3D) printed customized prosthesis in acetabular reconstruction of hip revision surgery.</p><p><strong>Methods: </strong>The related research literature on 3D printed customized prosthesis and its application in acetabular reconstruction of hip revision surgery was searched by key words of \"3D printed customized prosthesis\", \"revision hip arthroplasty\", \"acetabular bone defect\", and \"acetabular reconstruction\" between January 2013 and May 2024 in Chinese and English databases, such as CNKI, Wanfang database, PubMed, <i>etc</i>. A total of 34 271 articles were included. After reading the literature titles, abstracts, or full texts, the literature of unrelated, repetitive, low-quality, and low evidence level was screened out, and a total of 48 articles were finally included for analysis and summary.</p><p><strong>Results: </strong>The bone growth and mechanical properties of 3D printed customized prosthesis materials are better than those of non-3D printed customized prosthesis, which further solves the problem of elastic modulus mismatch between the implant and natural bone caused by \"stress shielding\"; the porous structure and antibacterial coating on the surface of 3D printed customized prosthesis have good anti-bacterial effect. 3D printed customized prosthesis can perfectly match the patient's individual acetabular anatomical characteristics and defect type, thus improving the accuracy of acetabular reconstruction and reducing the surgical time and trauma.</p><p><strong>Conclusion: </strong>3D printed customized prosthesis can be used for precise and efficient individualized acetabular reconstruction in hip revision surgery with good early- and mid-term effectiveness. More optimized production technics and procedures need to be developed to improve the efficiency of clinical application and long-term effectiveness.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1414-1420"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.7507/1002-1892.202405090
Jiani Wu, Yingzi Jiang, Guanyu Wang, Liliao Wang, Jie Bao, Jun Wang
Objective: To investigate the anti-adhesive effect and underlying mechanism of dynamic and static stress stimulation on the early healing process of rat Achilles tendon injury.
Methods: Achilles tendon tissues of 15 male Sprague Dawley (SD) rats aged 4-6 weeks were isolated and cultured by enzyme digestion method. Rat Achilles tendon cells were treated with tumor necrosis factor α to construct the Achilles tendon injury cell model, and dynamic stress stimulation (dynamic group) and static stress stimulation (static group) were applied respectively, while the control group was not treated. Live/dead cell double staining was used to detect cell activity, ELISA assay was used to detect the expression of α smooth muscle actin (α-SMA), and real-time fluorescence quantitative PCR was used to detect the mRNA expression of collagen type Ⅰ (COL1A1), collagen type Ⅲ (COL3A1), and Scleraxis (SCX). Thirty male SD rats aged 4-6 weeks underwent Achilles tendon suture and were randomly divided into dynamic group (treated by dynamic stress stimulation), static group (treated by static stress stimulation), and control group (untreated), with 10 rats in each group. HE staining and scoring were performed to evaluate the healing of Achilles tendon at 8 days after operation. COL1A1 and COL3A1 protein expressions were detected by immunohistochemical staining, α-SMA and SCX protein expressions were detected by Western blot, and maximum tendon breaking force and tendon stiffness were detected by biomechanical stretching test.
Results: In vitro cell experiment, when compared to the static group, the number of living cells in the dynamic group was higher, the expression of α-SMA protein was decreased, the relative expression of COL3A1 mRNA was decreased, and the relative expression of SCX mRNA was increased, and the differences were all significant ( P<0.05). In the in vivo animal experiment, when compared to the static group, the tendon healing in the dynamic group was better, the HE staining score was lower, the expression of COL1A1 protein was increased, the expression of COL3A1 protein was decreased, the relative expression of SCX protein was increased, the relative expression of α-SMA protein was decreased, and the tendon stiffness was increased, the differences were all significant ( P<0.05).
Conclusion: Compared with static stress stimulation, the dynamic stress stimulation improves the fibrosis of the scar tissue of the rat Achilles tendon, promote the recovery of the biomechanical property of the Achilles tendon, and has obvious anti-adhesion effect.
{"title":"[Study on anti-adhesion effect and mechanism of dynamic and static stress stimulation during early healing process of rat Achilles tendon injury].","authors":"Jiani Wu, Yingzi Jiang, Guanyu Wang, Liliao Wang, Jie Bao, Jun Wang","doi":"10.7507/1002-1892.202405090","DOIUrl":"10.7507/1002-1892.202405090","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the anti-adhesive effect and underlying mechanism of dynamic and static stress stimulation on the early healing process of rat Achilles tendon injury.</p><p><strong>Methods: </strong>Achilles tendon tissues of 15 male Sprague Dawley (SD) rats aged 4-6 weeks were isolated and cultured by enzyme digestion method. Rat Achilles tendon cells were treated with tumor necrosis factor α to construct the Achilles tendon injury cell model, and dynamic stress stimulation (dynamic group) and static stress stimulation (static group) were applied respectively, while the control group was not treated. Live/dead cell double staining was used to detect cell activity, ELISA assay was used to detect the expression of α smooth muscle actin (α-SMA), and real-time fluorescence quantitative PCR was used to detect the mRNA expression of collagen type Ⅰ (COL1A1), collagen type Ⅲ (COL3A1), and Scleraxis (SCX). Thirty male SD rats aged 4-6 weeks underwent Achilles tendon suture and were randomly divided into dynamic group (treated by dynamic stress stimulation), static group (treated by static stress stimulation), and control group (untreated), with 10 rats in each group. HE staining and scoring were performed to evaluate the healing of Achilles tendon at 8 days after operation. COL1A1 and COL3A1 protein expressions were detected by immunohistochemical staining, α-SMA and SCX protein expressions were detected by Western blot, and maximum tendon breaking force and tendon stiffness were detected by biomechanical stretching test.</p><p><strong>Results: </strong><i>In vitro</i> cell experiment, when compared to the static group, the number of living cells in the dynamic group was higher, the expression of α-SMA protein was decreased, the relative expression of COL3A1 mRNA was decreased, and the relative expression of SCX mRNA was increased, and the differences were all significant ( <i>P</i><0.05). In the <i>in vivo</i> animal experiment, when compared to the static group, the tendon healing in the dynamic group was better, the HE staining score was lower, the expression of COL1A1 protein was increased, the expression of COL3A1 protein was decreased, the relative expression of SCX protein was increased, the relative expression of α-SMA protein was decreased, and the tendon stiffness was increased, the differences were all significant ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>Compared with static stress stimulation, the dynamic stress stimulation improves the fibrosis of the scar tissue of the rat Achilles tendon, promote the recovery of the biomechanical property of the Achilles tendon, and has obvious anti-adhesion effect.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 11","pages":"1391-1398"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.7507/1002-1892.202407005
Pi'nan Liu
Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease caused by mutations in the NF1 gene. The disease is characterized by neurofibromatosis, which simultaneously affects multiple systems such as nerves, skin, and bone, and has complex clinical manifestations. Since the National Institutes of Health (NIH) established diagnostic criteria in 1988, the diagnosis and treatment of NF1 have progressed significantly. However, due to the complexity of the disease and the lack of effective treatments, the diagnosis and treatment of NF1 still face many challenges. Strengthening multidisciplinary collaboration, improving and popularizing disease diagnosis and treatment strategies, and developing more effective drugs and treatment methods are the keys to further improve the treatment level of NF1 diseases.
{"title":"[Progress and prospects in diagnosis and treatment of neurofibromatosis type 1].","authors":"Pi'nan Liu","doi":"10.7507/1002-1892.202407005","DOIUrl":"10.7507/1002-1892.202407005","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease caused by mutations in the <i>NF1</i> gene. The disease is characterized by neurofibromatosis, which simultaneously affects multiple systems such as nerves, skin, and bone, and has complex clinical manifestations. Since the National Institutes of Health (NIH) established diagnostic criteria in 1988, the diagnosis and treatment of NF1 have progressed significantly. However, due to the complexity of the disease and the lack of effective treatments, the diagnosis and treatment of NF1 still face many challenges. Strengthening multidisciplinary collaboration, improving and popularizing disease diagnosis and treatment strategies, and developing more effective drugs and treatment methods are the keys to further improve the treatment level of NF1 diseases.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1166-1170"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To investigate the perioperative changes in serum interleukin 6 (IL-6) levels in elderly male patients with intertrochanteric fractures, and provide evidence for inflammatory control in this patient population.</p><p><strong>Methods: </strong>The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed, including 25 non-osteoporosis patients (T value>-2.5, group A) and 15 osteoporosis patients (T value≤-2.5, group B). In addition, 40 healthy men aged more than 60 years old were included as controls (group C) according to the age matching rule. There was no significant difference in age, smoking history, drinking history, body mass index, complications (hypertension and diabetes), alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, and total protein among the 3 groups ( <i>P</i>>0.05). Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1, 3, 5, and 7. IL-6 levels were measured using ELISA assay. Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B. Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B.</p><p><strong>Results: </strong>Preoperative IL-6 levels were significantly higher in groups A and B than in group C ( <i>P</i><0.05), with group B being significantly higher than group A ( <i>P</i><0.05). In groups A and B, IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased, approaching preoperative levels by postoperative day 7. IL-6 levels in group B were significantly higher than those in group A at all postoperative time points ( <i>P</i><0.05). Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B ( <i>P</i><0.05). Complications occurred in 4 patients (16.0%) in group A, including 2 cases of pulmonary infection, 1 case of urinary tract infection, and 1 case of heart failure, and in 3 patients (20.0%) in group B, including 2 cases of pulmonary infection and 1 case of gastrointestinal bleeding. There was no significant difference in the incidence of complications between the two groups ( <i>χ</i> <sup>2</sup>=0.104, <i>P</i>=0.747). There were 2 cases (8.0%) and 4 cases (26.7%) died within 1 year after operation in groups A and B, respectively, and there was no significant difference in 1-year mortality rates between the two groups ( <i>χ</i> <sup>2</sup>=2.562, <i>P</i>=0.109).</p><p><strong>Conclusion: </strong>Serum IL-6 levels significantly increase in the early postoperative period in elderly male patients with intertrochanteric fractures, especially in those with
目的研究老年男性转子间骨折患者围手术期血清白细胞介素6（IL-6）水平的变化，为该患者群体的炎症控制提供证据：回顾性分析2021年1月至2022年12月期间符合入选标准的40例60岁以上男性转子间骨折患者的临床资料，包括25例非骨质疏松症患者（T值>-2.5，A组）和15例骨质疏松症患者（T值≤-2.5，B组）。此外，根据年龄匹配规则，40 名 60 岁以上的健康男性被纳入对照组（C 组）。三组患者的年龄、吸烟史、饮酒史、体重指数、并发症（高血压和糖尿病）、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血尿素氮、肌酐和总蛋白均无明显差异（P>0.05）。术前、术后第 1、3、5 和 7 天采集 C 组受试者、A 组和 B 组患者的血清样本。采用 ELISA 法测定 IL-6 水平。采用皮尔逊相关分析评估了 A 组和 B 组不同时间点 IL-6 水平与 T 值之间的关系，并记录了 A 组和 B 组住院期间的术后并发症和 1 年死亡率：A组和B组术前IL-6水平明显高于C组（PPPPχ 2=0.104，P=0.747）。A组和B组分别有2例（8.0%）和4例（26.7%）患者术后1年内死亡，两组1年死亡率无明显差异（χ 2=2.562，P=0.109）：结论：老年男性转子间骨折患者术后早期血清IL-6水平明显升高，尤其是骨质疏松症患者。在围手术期监测炎症状态并及时控制炎症反应，可减少并发症的发生，提高这类患者的术后存活率。
{"title":"[Perioperative changes of serum interleukin 6 levels in elderly male patients with intertrochanteric fracture].","authors":"Xiangxu Chen, Huanyi Zhu, Wei Wu, Chuwei Tian, Liu Shi, Wenbin Fan, Cheng Zhang, Yingjuan Li, Hui Chen, Wei Gao, Yunfeng Rui","doi":"10.7507/1002-1892.202405057","DOIUrl":"10.7507/1002-1892.202405057","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the perioperative changes in serum interleukin 6 (IL-6) levels in elderly male patients with intertrochanteric fractures, and provide evidence for inflammatory control in this patient population.</p><p><strong>Methods: </strong>The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed, including 25 non-osteoporosis patients (T value>-2.5, group A) and 15 osteoporosis patients (T value≤-2.5, group B). In addition, 40 healthy men aged more than 60 years old were included as controls (group C) according to the age matching rule. There was no significant difference in age, smoking history, drinking history, body mass index, complications (hypertension and diabetes), alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, and total protein among the 3 groups ( <i>P</i>>0.05). Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1, 3, 5, and 7. IL-6 levels were measured using ELISA assay. Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B. Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B.</p><p><strong>Results: </strong>Preoperative IL-6 levels were significantly higher in groups A and B than in group C ( <i>P</i><0.05), with group B being significantly higher than group A ( <i>P</i><0.05). In groups A and B, IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased, approaching preoperative levels by postoperative day 7. IL-6 levels in group B were significantly higher than those in group A at all postoperative time points ( <i>P</i><0.05). Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B ( <i>P</i><0.05). Complications occurred in 4 patients (16.0%) in group A, including 2 cases of pulmonary infection, 1 case of urinary tract infection, and 1 case of heart failure, and in 3 patients (20.0%) in group B, including 2 cases of pulmonary infection and 1 case of gastrointestinal bleeding. There was no significant difference in the incidence of complications between the two groups ( <i>χ</i> <sup>2</sup>=0.104, <i>P</i>=0.747). There were 2 cases (8.0%) and 4 cases (26.7%) died within 1 year after operation in groups A and B, respectively, and there was no significant difference in 1-year mortality rates between the two groups ( <i>χ</i> <sup>2</sup>=2.562, <i>P</i>=0.109).</p><p><strong>Conclusion: </strong>Serum IL-6 levels significantly increase in the early postoperative period in elderly male patients with intertrochanteric fractures, especially in those with ","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1249-1253"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To investigate the feasibility and effectiveness of ulnar cortex transverse transport technique in treating upper extremity thromboangiitis obliterans (TAO).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 7 male patients with upper extremity TAO who were admitted and met the inclusion criteria between January 2019 and July 2022. The patients ranged in age from 32 to 50 years, with a mean age of 40.1 years. The disease duration ranged from 6 to 24 months, averaging 13.6 months. The smoking history ranged from 8 to 31 years, with a mean of 18.4 years. All patients presented with finger ulcers or gangrene, including 1 case affecting the thumb and index finger, 1 case affecting the index and middle fingers, 1 case affecting the middle and ring fingers, 1 case affecting only the ring finger, and 3 cases affecting the ring and little fingers. The preoperative visual analogue scale (VAS) score was 9.1±0.7. All patients underwent treatment with the ulnar cortext transverse transport technique. The wound healing time and the disappearance time of rest pain were recorded. The VAS score was used to assess the degree of hand pain before and after operation. Serum interleukin 6 (IL-6) levels were measured before operation and at 1 month after operation. Computed tomography angiography (CTA) of the affected limb was performed before operation and at 3 months after operation to evaluate changes in blood vessels. The clinical outcomes were evaluated at 1 year after operation based on the Patwa and Krishnan grading system.</p><p><strong>Results: </strong>All 7 patients were followed up 12-17 months, with an average of 13.7 months. All patients experienced successful healing of ulcers, with wound healing time ranging from 14 to 21 days, averaging 17.3 days. During the follow-up, no complication occurred, and there was no recurrence of ulcers. The disappearance time of rest pain ranged from 8 to 15 days, averaging 12.1 days. The pre- and post-operative (1-month) serum IL-6 levels were (25.1±5.9) pg/mL and (11.9±2.9) pg/mL, respectively, with a significant difference ( <i>t</i>=5.363, <i>P</i>=0.002). CTA examination at 3 months after operation revealed partial revascularization of upper extremity arteries and establishment of collateral circulation, showing significant improvement compared to preoperative status. The VAS scores at 1, 7, 28 days, and 6 months postoperatively were 6.4±0.8, 3.7±0.8, 0.6±0.8, and 0.1±0.4, respectively, all of which significantly improved compared to preoperative scores ( <i>P</i><0.05). Furthermore, the VAS scores gradually decreased over time, with significant differences observed between postoperative time points ( <i>P</i><0.05). At 1 year after operation, the effectiveness of all 7 patients were evaluated as excellent based on the Patwa and Krishnan grading system.</p><p><strong>Conclusion: </strong>The ulnar cortex transverse transport technique can imp
{"title":"[Preliminary application of ulnar cortex transverse transport technique in treatment of upper extremity thromboangiitis obliterans].","authors":"Xiaojin Mo, Chunnian He, Jian Zhou, Wei Chen, Kaiyu Nie, Zairong Wei, Shusen Chang","doi":"10.7507/1002-1892.202404096","DOIUrl":"10.7507/1002-1892.202404096","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility and effectiveness of ulnar cortex transverse transport technique in treating upper extremity thromboangiitis obliterans (TAO).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 7 male patients with upper extremity TAO who were admitted and met the inclusion criteria between January 2019 and July 2022. The patients ranged in age from 32 to 50 years, with a mean age of 40.1 years. The disease duration ranged from 6 to 24 months, averaging 13.6 months. The smoking history ranged from 8 to 31 years, with a mean of 18.4 years. All patients presented with finger ulcers or gangrene, including 1 case affecting the thumb and index finger, 1 case affecting the index and middle fingers, 1 case affecting the middle and ring fingers, 1 case affecting only the ring finger, and 3 cases affecting the ring and little fingers. The preoperative visual analogue scale (VAS) score was 9.1±0.7. All patients underwent treatment with the ulnar cortext transverse transport technique. The wound healing time and the disappearance time of rest pain were recorded. The VAS score was used to assess the degree of hand pain before and after operation. Serum interleukin 6 (IL-6) levels were measured before operation and at 1 month after operation. Computed tomography angiography (CTA) of the affected limb was performed before operation and at 3 months after operation to evaluate changes in blood vessels. The clinical outcomes were evaluated at 1 year after operation based on the Patwa and Krishnan grading system.</p><p><strong>Results: </strong>All 7 patients were followed up 12-17 months, with an average of 13.7 months. All patients experienced successful healing of ulcers, with wound healing time ranging from 14 to 21 days, averaging 17.3 days. During the follow-up, no complication occurred, and there was no recurrence of ulcers. The disappearance time of rest pain ranged from 8 to 15 days, averaging 12.1 days. The pre- and post-operative (1-month) serum IL-6 levels were (25.1±5.9) pg/mL and (11.9±2.9) pg/mL, respectively, with a significant difference ( <i>t</i>=5.363, <i>P</i>=0.002). CTA examination at 3 months after operation revealed partial revascularization of upper extremity arteries and establishment of collateral circulation, showing significant improvement compared to preoperative status. The VAS scores at 1, 7, 28 days, and 6 months postoperatively were 6.4±0.8, 3.7±0.8, 0.6±0.8, and 0.1±0.4, respectively, all of which significantly improved compared to preoperative scores ( <i>P</i><0.05). Furthermore, the VAS scores gradually decreased over time, with significant differences observed between postoperative time points ( <i>P</i><0.05). At 1 year after operation, the effectiveness of all 7 patients were evaluated as excellent based on the Patwa and Krishnan grading system.</p><p><strong>Conclusion: </strong>The ulnar cortex transverse transport technique can imp","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1242-1248"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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