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Objective: To compare the curative effect of tarsal sinus approach with open reduction and internal fixation and lateral "L"-shaped approach with open reduction and internal fixation for the treatment of calcaneal fractures. Methods: 86 patients with calcaneal fractures who were treated at the Affiliated Hospital of North Sichuan Medical College from October 2016 to June 2017 were enrolled. The patients were divided into the control group and the observation group according to the random number table method, and 43 patients in both groups. The control group was treated with lateral "L"-shaped approach with open reduction and internal fixation. The observation group was treated with tarsal sinus approach with open reduction and internal fixation. The operation time, hospitalization time, fracture healing time, sputum-hind foot function, VAS score, B?hler angle, Gissane angle and postoperative complication rate were compared between the two groups. Results: There was no difference in the operation time and fracture healing time between the two groups(P>0.05). The hospitalization time of the observation group was shorter than that of the control group(P<0.05). The talus-hind foot function excellent rate in the observation group was higher than that in the control group(P <0.05). There were no significant differences in VAS score, B?hler angle and Gissane angle between the two groups before and 12 months after operation(P>0.05). At 12 months after operation, the VAS scores of both groups were significantly lower than those before operation, and the B?hler angle and Gissane angle were significantly higher than those before operation(P<0.05). The incidence rate of postoperative complications in the observation group was lower than that in the control group(P<0.05). Conclusion: The sacral sinus approach and the lateral "L" approach with open reduction and internal fixation can effectively treat calcaneal fractures. However, tarsal sinus approach can improve ankle-hind foot function more effectively, with shorter hospitalization time and lower incidence of postoperative complications. [ABSTRACT FROM AUTHOR]

目的 观察富血小板血浆(PRP)在胸部正中切口术后创面难愈并发胸骨骨髓炎治疗中的应用。方法选取胸部正中切口术后创面难愈并发胸骨骨髓炎患者65例,根据是否使用RPR分为观察组33例和对照组32例;对照组采取基础治疗及持续负压伤口疗法,观察组同时采用RPR治疗;治疗前及治疗后2周,检测血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、促红细胞生成素(EPO),行压疮愈合计量表(PUSH)评分;记录窦道封闭时间、创面愈合时间、二次手术例数、窦道复发情况、住院时间。结果 两组治疗前血清CRP、TNF-α、EPO水平及PUSH评分差异无统计学意义(P均> 0. 05),治疗后血清CRP、TNF-α及PUSH评分均降低而EPO水平均升高(P均<0. 05);与对照组治疗后比较,观察组血清CRP、TNF-α及PUSH评分均降低而EPO水平均升高(P均<0. 05)。观察组窦道封闭时间、创面愈合时间、住院时间均短于对照组(P均<0. 05),二次手术比例低于对照组(P <0. 05),但两组窦道复发情况差异无统计学意义。结论 胸部正中切口术后创面难愈并发胸骨骨髓炎患者采用PRP治疗,能降低炎性因子水平、提高EPO水平,进而促进窦道封闭、创面愈合。 [ABSTRACT FROM AUTHOR]

In recent years, bone fractures and nonunion caused by various factors such as trauma and infection were all medical problems that threatened human safety and quality of life, in order to promote the therapeutic effect for such patients, there was a need to clarify the pathophysiology as well as the corresponding biological mechanisms of bone formation and renewal. Bone tissue is a type of extracellular matrix mineralization, and can repair itself according to its own needs dynamically, bones also had blood vessels and nerve tissue activity, so the repair process of fractures not only consist of complex role of cytokines of various organizations but also of nerve and blood supply. Currently, clinical research on neuropeptides gradually increased, and a growing number of reports indicated that neuropeptides healing and rebuilding process could play an important role in the fracture, probably due to the body’s nerves and they also play a relevant role in regulating and stimulating bone cells and other factors change. This paper accordingly review on the impact of neuropeptide CGRP(calcitonin gene-related peptide, Calcitonin gene-related peptide), SP(P substance, Substance P), NPY(neuropeptide Y,Neuropeptide Y) on chondrocytes in order to serve the clinic better. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy of total hip and half hip hemiarthroplasty for elderly femoral neck fractures. Methods: 70 cases of femoral neck fracture patients in our hospital were randomly divided into observation group and control group with 35 cases in each group, the observation group was given total hip replacement while the control group was given half hip replacement, the operation time, intraoperative blood loss, postoperative Harris scores and the function of hip joint, postoperative complications, pain rate and revision rate of two groups were compared. Results: In the observation group, the operation time and the amount of bleeding was higher than those of the control group,[(113.6±19.3)min,(432.1±32.7)m L vs(73.1±10.2)min,(201.3±30.1)m L](all P<0.05); The total excellent and good rate and Harris score of hip function assessment in the observation group was significantly better than that of control group [91.4%,(91.13±5.09) points vs 77.14%,(80.15±4.71)points](all P<0.05); The incidence of adverse reaction and the revision rate of the observation group was lower than that of control group(20.00%, 0.00% vs 22.85%, 5.71%), but, there was no significant difference(all P>0.05); The pain rate in observation group was 5.71%, significantly lower than 25.71% of the control group(P<0.05). Conclusion: Both two methods, with their own advantages and disadvantages, were effective in the treatment for the elderly patients with femoral neck fracture, for the elderly patients with sensitive painfulness and more activity, the total hip arthroplasty will be a prior therapy. [ABSTRACT FROM AUTHOR]