ObjectiveTo investigate the expressions of stromal cell-derived factor-1 (SDF-1) and chemokine receptor-4 (CXCR4) in local tissues of perianal abscess and their relationships with clinicopathological features and prognosis of patients.MethodsA total of 47 patients with perianal abscess (perianal abscess group) and 58 patients with mixed hemorrhoids (mixed hemorrhoids group) were selected for the study. The tissues were collected during the operation. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expressions of SDF-1 mRNA and CXCR4 mRNA in local tissues of the two groups, the positive expressions of SDF-1 protein and CXCR4 protein in local tissues were detected by immunohistochemistry, and the relationships between the expressions of SDF-1 and CXCR4 protein and the clinical characteristics, prognosis of patients were analyzed.ResultsThe expression levels of SDF-1 mRNA and CXCR4 mRNA in the perianal abscess group were higher than those in the mixed hemorrhoids group, and the positive rates of SDF-1 protein and CXCR4 protein in the perianal abscess group were higher than those in the mixed hemorrhoids group too (P<0.05). The expressions of SDF-1 protein and CXCR4 protein in perianal abscess tissues were both not related to sex, age, location of abscess, and course of disease (P>0.05), but was related to abscess diameter, healing time, and anal fistula (P<0.05). The non-recurrence rates of SDF-1 protein-negative group and CXCR4 protein-negative group were lower than those of SDF-1 protein-positive group and CXCR4 protein-positive group respectively (P<0.05).ConclusionSDF-1 and CXCR4 molecular are up-regulated in the local tissues of perianal abscess, which are related to the size of abscess, healing time, anal fistula, and recurrence of patients.
Objective To compare the effectiveness and advantages of the double reverse traction reduction technique versus open reduction internal fixation for treating complex tibial plateau fractures. Methods A clinical data of 25 patients with Schatzker type Ⅴ or Ⅵ tibial plateau fractures, who met the selection criteria and were admitted between January 2019 and January 2023, was retrospectively analyzed. Thirteen patients underwent double reverse traction reduction and internal fixation (double reverse traction group), while 12 patients underwent open reduction and internal fixation (traditional open group). There was no significant difference in the baseline data (age, gender, injury mechanism, Schatzker classification, interval between injury and operation) between the two groups (P>0.05). The effectiveness were evaluated and compared between the two groups, included operative time, intraoperative blood loss, incision length, hospital stay, full weight-bearing time, complications, fracture healing, Rasmussen radiological score (reduction quality), knee Hospital for Special Surgery (HSS) score, and knee flexion/extension range of motion. Results The double reverse traction group demonstrated superior outcomes in operative time, blood loss, hospital stay, incision length, and time to full weight-bearing (P<0.05). Two patients in traditional open group developed incisional complications, while the double reverse traction group had no complications. There was no significant difference in the incidence of complication between the two groups (P>0.05). All patients were followed up 24-36 months (mean, 30 months), with no intergroup difference in follow-up duration (P>0.05). Fractures healed in both groups with no significant difference in healing times (P>0.05). At 6 months after operation, Rasmussen radiological scores and grading showed no significant difference (P>0.05); the double reverse traction group had significantly higher HSS scores and grading compared to the traditional open group (P<0.05). At 12 months after operation, knee flexion/extension range of motion were significantly greater in double reverse traction group than in traditional open group (P<0.05). Conclusion Double reverse traction reduction offers advantages over traditional open reduction internal fixation, including shorter operative time, reduced blood loss, minimized soft tissue trauma, and improved joint functional recovery. It is a safe and reliable method for complex tibial plateau fractures.