Locking compression plate+T-type steel plate for postoperative weight bearing and functional recovery in complex tibial plateau fractures

Complex tibial plateau fractures can seriously affect quality of life and physical and mental health of patients.The anatomical relationship between the proximal tibial bone and soft tissue is complex,resulting in different types of tibial plateau fractures.Violent trauma can lead to displaced fracture,serious soft tissue injury,and potentially,dislocation of the knee joint.Therefore,tibial plateau fractures are extremely unstable.AIM To assess the use of locking compression plate(LCP)+T-type steel plate for postoperative weight bearing and functional recovery of complex tibial plateau fractures.METHODS Ninety-seven patients with complex tibial plateau fractures who underwent surgery at our hospital were selected for retrospective study.Forty-nine patients had been treated with LCP+T-type steel plate limited internal fixation(study group),and 48 patients with bilateral ordinary steel plate support(control group).The operation process index,postoperative rehabilitation related index,Rasmussen score of the knee joint,tibial plateau varus angle(TPA),tibial plateau retroversion angle(PA),and surgical complications of the two groups were compared.RESULTS The operation time and intraoperative bone graft volume in the study group were lower than those in the control group(P<0.05).There were no significant differences in surgical bleeding,anterior external incision length,postoperative drainage,hospital stay duration,and fracture healing time between the groups(P>0.05).There was no significant difference in the TPA and PA angle between the groups immediately and 18 mo after surgery(P>0.05).At 12 mo after surgery,the Rasmussen scale score was higher in the study group than in the control group(P<0.05).There was no significant difference in the Rasmussen scale score at 18 mo after surgery,and the radiology score at 12 and 18 mo after surgery,between the two groups(P>0.05).The postoperative complication rate in the study group(3.77%)was lower than that in the control group(15.09%;P<0.05).CONCLUSION LCP+T-type steel plate internal fixation has advantages in terms of minimizing trauma and enabling early postoperative functional exercise,promoting functional recovery and lower limb weight-bearing,and reducing postoperative complications.

Expression of MUC1 and its significance in hepatocellular and cholangiocarcinoma tissue

AIM： To investigate the relation between MUC1 expression, distribution, and prognosis in hepatocellular and cholangiocarcinoma （HCC and CC） and cirrhotic liver tissues, and their significance in HCC and CC diagnosis. METHODS： Expression and distribution of MUC1 were examined by immunohistochemical assay with anti-MUC1 mAb in 59 samples of HCC and 37 samples of CC, 20 samples of cirrhotic liver tissues, and 10 samples of normal liver tissues, seeking possible associations between MUC1 positive expression, distribution in HCC and CC （primary liver cancer, PLC） cases and the studied clinical data. RESULTS： Immunohistochemical analysis of MUC1 expression showed that in the 96 PLC samples, 68 （70.8%） were strong positive, and 6 （6.2%） were weak positive. Only 4 in the 20 cirrhotic liver tissues were found to be weak positive, while no expression of MUC1 was detected in normal liver tissues. Apparently, the high expression rate of MUC1 in PLC tissues was statistically significant in comparison to that in cirrhotic and normal liver tissues. The expressed MUC1 protein, stained in dark brownish or brownish-yellow particles, chiefly localized on the cancer cell membranes or in cytoplasm. In the 68 strong positive samples, 40 were detected on cell membrane and the other 28 were in cytoplasm. In addition, follow-up studies of those PLC cases demonstrated that MUC1 expression on cell membrane or in cytoplasm was closely associated with PLC prognosis. The expression of HUC1 in PLC had little statistical significance in respect of the pathological types and sizes of the tumors, but a strong relationship regarding histological differentiation, metastasis of lymph nodes, portal canal emboli, and post-operational recurrence of the carcinomas. After 3 years of tumor excision, the metastasis rate in MUC1 positive expression group （67.6%） was much higher than that in MUC1 weak expression group （33.3%） and negative expression group （31.8%）, and thus the survival rate in MUC1-positive expression group was significantly different from that in weak and negative expression groups. CONCLUSION： Expression and localization of MUC1 proteins in primary liver carcinomas （PLCs） may act as prognostic markers, and MUC1 molecules might be helpful in differential diagnosis.

Study on the effect of clopidogrel combined with ezetimibe in the treatment of cerebral infarction

Objective:To investigate the effect of clopidogrel combined with ezetimibe on cerebral infarction.Methods:110 patients with acute cerebral infarction treated in our hospital from January 2016 to December 2018 were selected as study object. The clinical case data were retrospectively analyzed. According to different treatment options, they were divided into the observation group (using clopidogrel combined with ezetimibe,n=41), the control group 1 (treated with clopidogrel,n=39) and the control group 2 (using clopidogrel combined with atorvastatin,n=30). Finally, the serum levels of folic acid (FA), ferritin, troponin I (cTnI), the blood lipid levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG) and internal carotid artery intima-media thickness (IMT) of three groups were compared. The National Institutes of Health Stroke Scale (NIHSS) score, Barthel score and efficacy of three groups were compared. Results: (1) There were no significant differences in the serum levels( FA, ferritin cTnI), the serum lipid levels (HDL-C, LDL-C, TC, TG), IMT, NIHSS scores, and Barthel scores between three groups (P>0.05).mAfter treatment, the FA and HDL-C values of control group 2 were higher than those of the control group 1 (P<0.05), and the observation group increased significantly compared with control group 2 (P<0.05). In addition, the levels of ferritin, cTnI, LDL-C, TC, TG, IMT, NIHSS score and Barthel score in the control group 2 were lower than those in the control group 1 (P<0.05), and the observation group was more significant than the control group 2 (P<0.05). (2) In terms of treatment efficiency, the observation group was the highest, the control group was 2 was the second, and the control group 1 was the lowest (P<0.05);(3) There was no significant difference among three groups (P>0.05).Conclusions:The combination of clopidogrel and ezetimibe in the treatment of cerebral infarction can effectively improve the blood lipid level, promote the metabolism of nerve function and reduce the formation of plaque. This program is safe and effective and worth recommending.

Widely tunable optical properties via oxygen manipulation in an amorphous alloy

The ability to widely tune the optical properties of amorphous alloys is highly desirable especially for their potential applications in optoelectronic devices.In this work,we demonstrate that introducing oxygen into an amorphous alloy system of Co-Fe-Ta-B enables the formation of various amorphous derivatives ranging from metals to semiconductors,and eventually to insulators.These oxygencontaining amorphous derivatives gradually become transparent with the opened bandgaps,leading to a continuous increase in their optical transmittance.Furthermore,the reflective metal-type amorphous alloy and transparent insulator-type amorphous oxide of the system can be integrated together to realize the full-color tuning over the entire visible spectral range.This provides a new way to develop large-area color coatings with high design flexibility and full-color tunability.We envisage that the design concept proposed in this work is also applicable to many other amorphous alloy systems,from which all types of amorphous materials including alloys,semiconductors and insulators may be developed to show unprecedented optical functionalities.

Augmented reality(AR)and fracture mapping model on middle-aged femoral neck fracture:A proof-of-concept towards interactive visualization

A thorough understanding of the fracture characteristics can assist the decision-making process for surgery.This study aimed to characterize the femoral neck fractures among middle-aged patients and illustrated a biomedical visualization method using a fracture mapping model and augmented reality.We collected plain radiography and computed tomography(CT)data from 156 adult patients with a femoral neck fracture.The descriptive study showed that Type I and Type II fractures accounted for 8(5%)and 64(41%)cases.In comparison,Type IV fractures accounted for 44(28%)and 40(25%)cases according to the Garden classification.Comminuted fractures and cortical defects were identified in 14.74%and 29.49%of the cases.A fracture mapping model was reconstructed based on the CT data and demonstrated the location and distribution of the major fracture lines surrounding the head-neck junction.We also illustrated the application of augmented reality technology to visualize and interact with the patient-specific fracture model and the fracture mapping model that facilitated education,training,and surgical planning.Future studies may consider mapping other biomechanical data,such as joint loading and stress distribution,and exploring artificial intelligence via deep reinforcement learning for computer-aided fracture reduction and procedure planning.

Gold-catalyzed intermolecular reaction of ynamides with 3-indolyl azides via an unexpected 1,2-alkyl migration

A gold-catalyzed intermolecular reaction of ynamides with 3-indolyl azides via the presumable α-imino gold carbenes has been developed, providing an alternative and efficient way for the synthesis of valuable 3-amino-β-carbolines in generally good to excellent yields. Importantly, this new protocol involves an unexpected 1,2-alkyl migration pathway.