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Objective: To investigate the clinical effect of NRD assisted Ilizarov technique in the treatment of infected bone and soft tissue defect of tibia., Methods: All 48 patients with infected bone and soft tissue defect of tibia were randomly divided into study group and control group from March 2013 to December 2020. There were 34 males and 14 females, aged from 24 to 55 years old with an average of (40.54±11.64) years old. There were 25 patients in the study group, including 17 males and 8 females, aged from 31 to 55 years old with an average of (41.36±9.69) years old. The study group were treated with NRD assisted with Ilizarov bone transport technique. There were 23 patients in control group, including 17 males and 6 females, aged from 24 to 53 years old with an average of(38.61±8.76) years old. The control group were treated with traditional bone transport technique. The curative rate, recurrence rate, incidence rate of pin track infection, time of using antibiotics, time of wound healing, time of carrying external fixation, time of bone transport, time of bone healing and postoperative function were used to evaluate the therapeutic effect of the two groups., Results: The follow-up period was from 12 to 62 months with an average of (33.0±7.2) months. At the final follow-up, there was no significant difference in the curative rate between the two groups ( P >0.05). The recurrence rate in the study group was lower than that in the control group( P <0.05). The incidence of pin track infection in the study group was lower than that in the control group ( P <0.05). The time of using antibiotics and wound healing in the study group was shorter than that in the control group( P <0.05). There was no significant difference in the time of bone transport and carrying of external fixation between the two groups( P >0.05). There was no significant difference in bone healing and postoperative function between the two groups( P >0.05)., Conclusion: NRD assisted Ilizarov technique can achieve satisfactory results in the treatment of infected bone and soft tissue defect of tibia and shorten the treatment period and the time of using antibiotics. It is worthy of development in clinic.

Objective: To study the treatment and therapeutic effects in the shearing-type and comminuted talar body fractures., Methods: From October 1988 to September 2005,34 patients with shearing-type or comminuted talar body fractures were followed up. There were 19 males and 15 females ranged from 13 to 55 years (averaged 28.8 years). The disease course ranged from 3 to 14 days (averaged 6.0 days). Ten patients with a displacement of no more than 3 mm were treated with plastic cast. Eighteen patients were treated with open reduction and internal fixation, 6 patients were treated with joint fusion. The assessment of clinical efforts depend on patients' ache, active range of the joint and limp., Results: The mean follow up was 5.04 years (ranged from 3 to 19 years). All the patients were healed. The clinical outcomes were evaluated according to Hawkins evaluation score in which ache, active range of the joint and limp was respectively acssessed. There were 6 patients reached an excellent result, 9 good, 11 fair and 8 poor. Fifteen patients had osteonecrosis, 18 patients had traumatic arthritis of ankle joint, and 14 patients had traumatic arthritis of subtalar joint., Conclusion: Patients whose displacement of fracture is not more than 3 mm should be treated with plastic cast. Operation and internal fixation should be performed in patients whose displacement of fracture is more than 3 mm after close reduction. Joint fusion should be performed in patients whose talar body fracture is comminuted severely and the surface of joint can not be repaired. The patients of talar body scissored fracture or comminuted fracture has bad prognosis.

Objective: To explore the effects of different doses of puerarin on proliferation of cultured vascular endothelial cells in vitro., Methods: The hearts of three new-born SD rats 5 days old were mechanically minced and enzymatically digested with collagenase and trypsin, then vascular endothelial cells were counted, washed and resuspended in Dulbecco's minimum essential medium (DMEM) added with 20% heat inactivated fetal calf serum, then inoculated in 2% gelatin-coated tissue culture flasks. Vascular endothelial cells at passage 3 were used in the experiment. Except for the normal control group, the vascular endothelial cells were cultured with puerarin in various concentrations (0.01, 0.1, 1, 10 and 100 micromol/L) for 24 hours, and the morphology and the number of the cultured endothelial cells were observed. Methyl thiazolyl tetrazolium (MTT) colorimetry was used to determine the proliferation of the cultured vascular endothelial cells. Flow cytometry (FCM) were used to detect the proliferation index (PI) of the vascular endothelial cells and the expression of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemical method., Results: The cell morphology was normal under the inverted microscope in each group. The number and proliferation activities of vascular endothelial cells were significantly increased by 1, 10 and 100 micromol/L puerarin compared with those of the blank control group, especially the 100 micromol/L puerarin group, and there were no remarkable changes in with 0.1 micromol/L and 0.01 micromol/L puerarin groups. The same results were seen in the positive rate of PCNA expression and PI., Conclusion: Puerarin has dose-dependent effects on the proliferation activity of vascular endothelial cells.

Objective: To study the clinical effect of tractive reduction with external fixator and arthroscopically assisted treatment for tibial plateau fractures., Methods: From February 2003 to January 2005, a total of 26 cases with tibial plateau fractures were reviewed. There were 4 cases of type I fracture, 5 type II, 4 type III, 6 type IV, 5 type V and 2 type VI based on Schatzker criteria. Before operation, X-ray examination and CT scanning were done. During operation, the dissociative fragments were reconstructed by tractive reduction with external fixator arthroscopically and fixated with screws or plates., Results: All the fractures were healed within 1.5 - 4 months, with no severe complications such as poor wound healing, infection or osteofascial compartment syndrome. All patients that were followed up for 7 - 21 months (mean, 16 months) showed no traumatic osteoarthritis, inversion or eversion of the knee. According to the Rasmussen scoring system, the outcome was excellent in 11 cases, good in 13 and fair in 2, with total score of 27 +/- 2., Conclusions: As for Schatzker type I - VI tibial plateau fractures, tractive reduction with external fixator and arthroscopically assisted treatment is characterized by minimal invasion, fast fracture healing. It broadens operative interspace of articular cavity, improves accuracy of reduction, is beneficial for knee joint function to recover.