Objective To investigate the value of using Footscan system to evaluate the therapeutic effect of two internal fixation methods on calcaneus fractures. Methods From February 2006 to September 2006, 64 patients with fresh unilateral closed calcaneus fractures were randomly divided into two groups. The experimental group: 32 patients underwentminimally invasive open reduction and internal fixation with improved compressing plate and screw, including 28 males and 4 females aged 20-53 years old (average 36.7 years old); the course of disease was 3-14 days; there were 19 cases of type II, 11 of type III, and 2 of type IV according to Sanders fracture classification system. The control group: 32 patients underwent internal fixation of standard AO plate via L-shaped incision, including 29 males and 3 females aged 18-56 years old (average 37.1 years old); the course of disease was 4-15 days; there were 18 cases of type II, 11 of type III and 23 of type IV according to Sanders fracture classification system. No significant difference was noted between two groups in the general information (P gt; 0.05). At 1 and 2 years after operation, dynamic plantar pressure was measured using Footscan system, Maryland foot scores of two groups was compared, and statistical analysis was performed. Results All patients were followed up for 2 years. No infection, cuticular border necrosis, and sural nerve distal end injury occurred in the experimental group, whereas in the control group, 3 patients suffered from cuticular border necrosis and recovered after dressing, and 1 patient had sural nerve distal end injury with decreased sensation in local skin. At 1 and 2 years after operation, in the control group, there were significant differences between the injured foot and the normal foot in terms of impulse, instep index, motion range of subtalar joint, lateral displacement of footplate pressure center, and calcaneal width when patients stood on both feet (P lt; 0.05), whereas in the experimental group, no significant differences were noted between the injured foot and the normal foot in terms of the above parameters (P gt; 0.05). Significant differences were noted between two groups in terms of the above parameters (P lt; 0.05). The Maryland score 1 yearafter operation was (86.74 ± 8.56) points for the experimental group and (71.24 ± 10.06) points for the control group; at 2 years after operation, it was increased to (87.35 ± 8.49) points and (72.41 ± 9.69) points, respectively, indicating there was a significant difference between two groups (P lt; 0.05). Conclusion Operative outcomes of internal fixation with improved compressing plate are superior to those of standard AO plate. Footscan system can provide a quantitative assessment on the operative effect of calcaneus fractures.
Objective To assess the effect of topical appl ication of 5-fluorouracil (5-FU) on intimal hyperplasia in rabbit vein graft. Methods Sixty-four male New Zealand white rabbits, aged 5 months and weighing 2.8-3.0 kg, were randomly divided into group A, B, C, and D (n=16 rabbits per group). Artery defect model was establ ished by cutting about 1 cm artery from the middle part of the dissociated left common carotid artery. A section about 3 cm was cut from the right external jugular vein, and the harvested vein was inverted and end-to-end anastomosed to the artery defect with 9-0 non-traumatic suture. After anastomosis, the extima of the grafted veins in group A, B, and C was completely wrapped with cotton sheet (12 mm × 30 mm × 1 mm in size) immersed by 5-FU at a concentration of 50.0, 25.0, and 12.5 mg/mL, respectively, and eachvein was treated 5 times (1 minute at a time). In group D, the extima of the graft veins was treated with normal sal ine instead of 5-FU. The grafted veins were obtained 1, 2, 4, and 6 weeks after operation, HE staining and Masson staining were preformed for histological changes of grafted vein wall, prol iferating cell nuclear antigen (PCNA) immunohistochemistry staining and TUNEL label ing staining were conducted for prol iferation and apoptosis of smooth muscle cell of the grafted vein, and transmission electron microscope observation was performed for cellular ultrastructure. Results The HE staining, Masson staining, and PCNA immunohistochemistry staining showed that the thickness of intima in group A and B was obviously less than that in group C and D at 1, 2, 4, and 6 weeks after operation, and the prol iferation cells in group A and B were less than that in group C and D at 1, 2, and 4 weeks after operation. The thickness of the intima, the degree of intima hyperplasia, the degree of vessel lumen stenosis of four groups at different time points were as follows: at 1 week after operation, group A [(12.69 ± 1.68) μm, 0.73 ± 0.05, 0.025 ± 0.003], group B [(17.52 ± 2.01) μm, 0.86 ± 0.06, 0.027 ± 0.004], group C [(21.92 ± 1.85) μm, 1.06 ± 0.09, 0.036 ± 0.006] and group D [(26.45 ± 3.86) μm, 1.18 ± 0.08, 0.041 ± 0.005]; at 2 weeks after operation, group A [(24.61 ± 2.91) μm, 0.86 ± 0.06, 0.047 ± 0.003], group B [(37.28 ± 2.78) μm, 1.17 ± 0.09, 0.060 ± 0.004], group C [(46.52 ± 2.25) μm, 1.44 ± 0.08, 0.073 ± 0.003], and group D [(52.07 ± 3.29) μm, 1.45 ± 0.05, 0.081 ± 0.006]; at 4 weeks after operation, group A [(61.09 ± 6.84) μm, 1.38 ± 0.08, 0.106 ± 0.007], group B [(63.61 ± 8.25) μm, 1.40 ± 0.07, 0.107 ± 0.010], group C [(80.04 ± 7.65) μm, 1.64 ± 0.07, 0.129 ± 0.011], and group D [(84.45 ± 9.39) μm, 1.68 ± 0.10, 0.139 ± 0.014]; at 6 weeks after operation, group A [(65.27 ± 5.25) μm, 1.46 ± 0.07, 0.113 ± 0.005], group B [(65.82 ± 7.12) μm, 1.45 ± 0.05, 0.112 ± 0.011], group C [(84.45 ± 9.39) μm, 1.69 ± 0.09, 0.135 ± 0.007], and group D [(87.27 ± 8.96) μm, 1.76 ± 0.05, 0.140 ± 0.012]. Group A and B were inferior to group C and D in terms of the above three parameters and cell prol iferation index 1, 2 and 4 weeks after operation (P lt; 0.05). Group A and B were superior to group C and D in terms of cell apoptosis index of intima and media 1 and 2 weeks after operation (P lt; 0.05). Transmission electron microscope observation showed that the synthetic cell organelles such as rough endoplasmic reticulum, golgi apparatus, and ribosome in group A and B were obviously less than those in group C and D (P lt; 0.05). Conclusion Topicalappl ication of 5-FU can effectively inhibit intima hyperplasia of the vein grafts.