Objective To compare the hemostatic effects and tourniquet induced side reactions of 2 different tourniquets in internal fixation of bilateral tibia and fibula fracture. Methods Between May 2008 and May 2010, 21 patients with bilateral tibia and fibula fracture were treated and randomly divided into 2 groups according to left and right l imbs. When steel plate fixation was performed, equil ibrium pressure pneumatic tourniquet (EPPT group) and common tourniquet (common group) were used to staunch the flow of blood respectively. The time of using tourniquet was 60 minutes, and the hemostatic pressure was 50 kPa. There were 12 males and 9 females with an age range of 17 to 58 years (mean, 32.5 years). Injurywas caused by traffic accident in 9 patients, by heavy pound in 6 patients, and fall ing from height in 6 patients. According to X-ray calssification, there were 15 cases of simple type, 3 cases of butterfly type, and 3 cases of comminuted type in EPPT group; there were 13 cases of simple type, 5 cases of butterfly type, and 3 cases of comminuted type in common group. The time from injury to operation was 3 to 72 hours (mean, 37.5 hours). Results The time of using tourniquet was (95.30 ± 4.19) minutes in EPPT group and (94.11 ± 5.16) minutes in common group, showing no significant difference (P gt; 0.05). All the incision of 2 groups healed by first intension. After 2 weeks of operation in common group, peroneal nerve injury occurred in 3 cases, and was cured by supporting nerve for 3 months; bl ister occurred in 1 case and was cured after dressing change for 3 weeks; and the injury rate was 19%. No compl ication occurred in EPPT group with an injury rate of 0. There was significant difference in the injury rate between 2 groups (P lt; 0.05). The hemostatic effects were excellent in 19 cases and good in 2 cases of EPPT group, were excellent in 10 cases, good in 3 cases, and poor in 8 cases of common group; the excellent and good rate were 100% and 61.9% respectively, showing significant difference (P lt; 0.05). All patients were followed up 3-24 months. Fracture healed without nonunion and deformity union in 2 groups. Conclusion Comparing to common tourniquet, the EPPT can provide good bloodless field, lower hemostatic pressure, and less tourniquet compl ication.
Objective To investigate the influence on matrix metalloproteinases (MMP) 3, 9, and 13 levels of human articular cartilage cells after blocking stromal cell derived factor 1 (SDF-1)/ chemokine receptor 4 (CXCR4) signaling pathway withAMD3100 and to define the function mechanism of AMD3100. Methods A total of 144 cartilage blocks from 12 osteoarthritis (OA) patients undergoing total knee arthroplasty (OA cartilage group) and 144 normal cartilage blocks (Mankin score of 0 or 1) from 12 patients undergoing traumatic amputation (normal cartilage group). OA cartilage group was further divided into subgroups A1, B1, and C1, and normal cartilage group into subgroups A2, B2, and C2. The cartilage tissues were cultured in DMEM solution containing 100 ng/mL SDF-1 and 1 000 nmol/L AMD3100 in subgroup A, 100 ng/mL SDF-1 and 1 000 nmol/L MAB310 in subgroup B, and 100 ng/mL SDF-1 in subgroup C, respectively. The levels of MMP-3, 9, and 13 were measured by ELISA; the expressions of MMP-3, 9, and 13mRNA were tested by RT-PCR. Results ELISA and RT-PCR results showed that the levels of MMP-3, 9, and 13 and the expressions of MMP-3, 9, and 13 mRNA were significantly lower in subgroup A than in subgroups B and C at the same time points (P lt; 0.05); the levels of MMP-3, 9, and 13 and the expressions of MMP-3, 9, and 13 mRNA were significantly higher in OA cartilage group than in normal cartilage group at the same time points (P lt; 0.05). Conclusion SDF-1 could induce overexpression and release of MMP-3, 9, and 13 in the articular cartilage through the SDF-1/CXCR4 signaling pathway; AMD3100 could reduce the mRNA expressions and secretion of MMP-3, 9, and 13 in OA cartilage by blocking the SDF-1/CXCR4 signaling pathway; but AMD3100 could not make the secretion of MMP-3, 9, and 13 return to normal levels in OA cartilage.
Objective To discuss the authenticity of reconstructing the anterior cruciate l igament (ACL) threedimensional digital model of normal adult knee joint by use of MRI. Methods The double knee joint specimens were selected from 20 fresh normal adult corpses and double knee joint of 20 normal adult volunteers, and were scanned with MRI; continuous image data of level thick 1.0 mm were acquired, and then these data were imported into Mimics 10.01 software for three-dimensional reconstruction; and full three-dimensional digital models were built, including the corpse specimens (corpsemodel group) and normal adult (normal model group). The relevance anatomy index of ACL were measured with easuring tool of Mimics 10.01 software, and double knee joint specimens of 20 fresh normal adult corpses were dissected, and the relevance data were measured (corpse specimens group). Results There was no significant difference in all indexes between corpse model group and corpse specimen group (P gt; 0.05), and between corpse model group and normal model group (P gt; 0.05). Conclusion The image data gathered by MRI could reconstruct the ACL three-dimensional digital model of normal adult knee joint, which has authenticity.
