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has good safety. It is an effective method for treating for the treatment of collateral ligament contracture of metacarpophalangeal joint.OBJECTIVE To observe early clinical effect of high tibial osteotomy combined with arthroscopy for elderly patients with knee osteoarthritis of medial compartment. METHODS Sixty-one elderly patients with medial compartment knee osteoarthritis were treated with high tibial osteotomy combined with arthroscopy from August 2017 to October 2018. Among them, including 17 males and 44 females, aged from 60 to 83 years old with an average of (67.87±6.45) years old. read more Weight bearing line (WBL) and femora-tibial angle (FTA) were analyzed to assess lower limb alignment before and 12 months after surgery. Visual analogue scale (VAS) score and Hospital for Special Surgery (HSS) score were used to evaluate knee pain and function before and 1, 3, 12 months after surgery. RESULTS All patients were followed up from 12 to 19 months with an average of (14.27±4.69) months. WBL was improved from (14.79±5.61) % before operation to (59.33±7.82) % at 12 months after operation (t=2.294, P less then 0.05), FTA was improved from (182.14±2.19) ° before operation to (171.54±3.16) ° at 12 months after operation (t=1.827, P less then 0.05) . VAS score decreased from 6.14±2.21 before operation to 3.64±0.92, 2.02±0.63 and 0.93±0.61 at 1, 3 and 12 months after operation (F=458.24, P less then 0.001), HSS score increased from 49.66±13.79 to 58.39±9.26, 71.82±6.06 and 82.71±6.97 at 1, 3 and 12 months after operation (F=266.45, P less then 0.001) . Three patients had contralateral cortical fracture during surgery, whose osteotomy area healed well at 12 months after surgery. The incision healing of 4 cases was slow, while all healed at 3 to 4 weeks after surgery. CONCLUSION High tibial osteotomy combined with arthroscopy could adjust lower limb alignment effectively, relieve knee pain and functional dysfunction, which indicated a significant short term efficacy on the elderly patients with knee osteoarthritis of medial compartment.OBJECTIVE To observe clinical effects of platelet-rich plasma (PRP) intra-articular and extra-articular injection for patients with knee osteoarthritis (KOA), and analyze its safety and clinical efficacy. METHODS From January to December 2017, 48 patients with KOA were randomly divided into observation group and control group, 24 cases in each group. The observation group was treated with intra-articular injection of PRP (2 ml) and extra-articular injection of PRP (2 ml), once a week, for three times, including 8 males and 16 females with an average of (58.04±7.87) years old ranging from 43 to 68 years old, the courses of disease ranged from 1 to 8 years with an average of (4.69±1.96) years, the body mass index (BMI) was (24.53±5.26) kg/m 2 . The control group was treated with intra-articular injection of sodium hyaluronate (20 mg), extra-articular injection of analgesic drug (2 ml for one point), once a week, for three times, including 7 males and 17 females with an average of (60.54±8.93) years old ranging ontrol group at 6 months after treatment (P less then 0.05) . CONCLUSION Intra-articular and extra-articular injection of PRP could relieve pain symptoms and improve function of knee joint with higher safety, although the short-term effect is not significantly different from traditional treatment, its medium-long-term effect is stable. It is a safe and effective method for the treatment of knee osteoarthritis.OBJECTIVE To compare clinical effects of calcaneal traction and external fixator fixation of fractional delayed surgery in treating type C Pilon fractures. METHODS From January 2012 to December 2017, clinical data of 45 patients with tibial Pilon fractures were respectively analyzed. There were 24 patients in traction group, including 16 males and 8 females, aged from 21 to 57 years old with an average age of (38.6 ±10.5) years old; 18 patients caused by falling down, 6 patients caused by traffic accident; 15 patients on the left side and 9 patients on the right side; according to AO/OTA classification, 3 patients classified type C1, 9 patients classified type C2 and 12 patients classified type C3; treated by calcaneal traction on the first stage, and open reduction and internal fixation on the second stage. There were 21 patients in external fixation group, including 15 males and 6 females, aged from 19 to 58 years old with an average age of (37.8 ±11.2) years old; 17 patients caused by falling down, 4 patienal fixation. The operation of calcaneus traction is simple, while external fixation may be increase the number of operation times, but external fixation has more advantages in reducing preoperative pain, shortening preoperative waiting days and hospitalization time than traction.Medicinal guide theory is a unique theory of Chinese medicine, which bears some similarities to the modern targeted drug delivery system. Modern pharmacological studies have revealed some scientific connotations of the essence of medicinal guide, which may be related to the changes of drug distribution and metabolism it induces. In modern medicine, phosphodiesterase type 5 (PDE5) inhibitors are widely used in the treatment of impotence or ED, with the main underlying mechanisms of increasing arterial blood supply and improving penile vascular endothelial function. With the gradual integration of traditional Chinese medicine (TCM) with modern medicine, PDE5 inhibitors are also commonly used for the treatment of ED in integrated traditional Chinese and Western medicine, based on the mainstream view of promoting blood circulation and invigorating the kidney. However, PDE5 inhibitors also have some remarkable characteristics and advantages of medicinal guide drugs, which can be widely incorporated into the treatment system of ED under the guidance of TCM theories and play a huge role in enhancing and expanding therapeutic efficacy.Epigenetic changes induced by obesity can lead to male infertility phenotype. As for the relationship between obesity and male infertility, early studies mostly focused on the endocrine aspect. Recent studies have found that obesity can cause epigenetic changes, such as DNA methylation, residual histone modification, small RNA, etc, affecting sperm maturation and development. DNA methylation is a regulatory marker on cytosine residue of cytosine-phosphate-guanine dinucleotide. Obesity leads to abnormal DNA methylation, changes mRNA expression abundance, affects imprinted gene expression induses imprinted gene diseases. The modification methods of residual histones include methylation, acetylation, etc. They can interact or cooperate to ensure the normal growth and development of sperm. Obesity changes methylase and acetylase activities and directly affects methylation and acetylation of residual histones, and the expression of micro-RNAs in sperm as well, consequently causing sperm defects. This article reviews epigenetic changes caused by obesity and the mechanism of male infertility.
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