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A well-studied subject of epigenetics, the histone methylation located at lysine and arginine is overseen via methyltransferases and demethylases. Lysine-specific demethylase 4A (KDM4A) comprises a lysine demethylase and possesses specificity for H3K9me3 and H3K36me3, which is capable of being used in order to activate histone transcription. Our team examined the expression of KDM4A within Sprague Dawley (SD) rats and further investigated the mechanism via which this phenomena regulates osteogenic variation within the present study. The overexpression of KDM4A facilitated the process of osteoblast differentiation in bone mesenchymal stem cells (BMSC), while the knocking down differentiation via osteoblast was restrained via the suppression of the expression of Runx2, Osterix, alkaline phosphatase (ALP), and osteocalcin (OCN). Knocking down KDM4A lowered levels of the promoter expression of Runx2, osterix, and OCN, and raised levels of H3K27me3 expression. The results demonstrated that KDM4A possesses a crucial role within the differentiation of osteoblasts and furthermore regulates the expression of Runx2, Osterix, and OCN via H3K9me3. The present research may provide new insights into the treatment of bone healing.

Improvements were made by us in several distally based pedicled flaps of the nutrient vessels of the saphenous nerve with lower rotation points. However, these flaps are still insufficient for trauma complicated by bone defects. Accordingly, we conducted a systematic study of the anatomic theory on distally based pedicled compound flaps of the nutrient vessels of the saphenous nerve and great saphenous vein with 30 lower limbs of adult cadavers injected with red gelatin through the femoral artery. It is found that the nutrient vessels of the saphenous nerve-great saphenous vein consist of arteria saphena, fascial cutaneous branches of the inferior medial genicular artery intermuscular spatium branches of the posterior tibial artery, osteocutaneous perforators, superior ankle perforators, medial anterior malleolus perforators, and fascial perforators of the ankle tunnel region. Musculocutaneous perforators of the interior gastrocnemius muscle also enter the nutrient vessels of cutaneous nerve-superficial vein. From May 2004 to February 2007, 23 cases of skin flaps for treating defective and infectious wound, 10 cases of musculocutaneous flaps for treating ulcus in the lower segment of the leg, medullitis, and exposure of bone, 3 cases for medial calcaneus medullitis, 7 cases of skeletal flaps for treating tibial defects and nonunion of calcaneal bone. In 2-15-month follow-ups all cases presented with survived flaps, and healed surfaces of the wound and the osteomyelitis. For cases of bone nonunion, it showed that the nonunion healed after 18 weeks, with recovery of work ability after year. Three types of the distally based pedicled flaps or compound flaps of vessels of different perforating branches can be designed for repairing tissue defects caused by trauma, such as bone defects in the distal leg, nonunion, large necrotic space as well as traumatic surface of the foot and ankle.

Objective T1- and T2-weighted magnetic resonance images (MRI) can reveal lumbar redundant nerve roots (RNRs), a result of chronic compression and nerve elongation associated with pathogenesis of cauda equina claudication (CEC) in degenerative lumbar canal stenosis (DLCS). The study investigated effects of lumbar lordosis angle and range of motion on functional recovery in lumbar stenosis patents with and without RNRs. Methods A retrospective study was conducted of 93 lumbar spinal stenosis patients who underwent decompressive surgery. Eligible records were assessed by 3 independent blinded radiologists for presence or absence of RNRs on sagittal T2-weighted MR (RNR and non-RNR groups), pre- and post-operative JOA score, lumbar lordosis angle, and range of motion. Results Of 93 total patients, the RNR group (n = 37, 21/37 female) and non-RNR group (n = 56; 31/56 female) had similar preoperative conditions (JOA score) and were not significantly different in age (mean 64.19 ± 8.25 vs. 62.8 ± 9.41 years), symptom duration (30.92 ± 22.43 vs. 28.64 ± 17.40 months), or follow-up periods (17.35 ± 4.02 vs. 17.75 ± 4.29 mo) (all p > 0.4). The non-RNR group exhibited significantly better final JOA score (p = 0.015) and recovery rate (p = 0.002). RNR group patients exhibited larger lumbar lordosis angles in the neutral position (p = 0.009) and extension (p = 0.021) and larger range of motion (p = 0.008). Conclusions Poorer surgical outcomes in patients with RNRs indicated that elevated lumbar lordosis angle and range of motion increased risks of RNR formation, which in turn may cause poorer post-surgical recovery, this information is possibly useful in prognostic assessment of lumbar stenosis complicated by RNRs.

The mid-to-lower segment of tibiofibular fractures (MLTFs) is commonly encountered in clinical practice, which is conventionally treated by the double-incision surgical approach. However, the double-incision approach frequently makes the closure of the wound extremely difficult and sometimes results in necrosis of skin around fractured sites. In the present study, our experience of using a single-incision surgical approach for treating MLTF was exhibited. From February 2005 to December 2013, the clinical outcomes of 212 patients with MLTFs who underwent either double-incision approach or single-incision approach were retrospectively evaluated and compared. Both groups were similar with respect to injury mechanism and all patients were followed up with the efficacies of treatment evaluated by Johner-Wruth criteria. The results demonstrated that the effective rate and the rate of excellent and good efficacy in the single-incision group were significantly higher than those in the double-incision group (P

In this paper, we demonstrate that 14 solutions from 34 of the combined KdV and Schwarzian KdV equation obtained by Li [Z.T. Li, Appl. Math. Comput. 215 (2009) 2886-2890] are wrong and do not satisfy the equation. The other a number of exact solutions are equivalent each other.

In this Letter, different kinds of solutions including breather-type soliton and two-soliton solutions, are obtained for the modified Korteweg-de Vries (M-KdV) equation by using bilinear form, the extended homoclinic test approach and dependent variable transformations. Moreover,we point out that the author did not obtain so-called periodic two-soliton solutions in W. Long (in press) [1].

A distally based flap pedicled with the nutrient vessel of the sural nerve has been widely applied in the clinic. An attempt was carried out to modify the distally based flap pedicled with the nutrient vessel of the lower rotation point sural nerve to reconstruct the soft-tissue defects in foreleg. For cases with complex bone defects, this flap was unsatisfactory for the reconstruction. A compound flap pedicled with the sural nerve and the lesser saphenous veins was investigated in the lower extremities of 30 human cadavers arterially infused with red gelatin. The results showed that the sural nerve and the lesser saphenous vein had the identical source of blood supply as the nutrient vessel of muscle, fibula, and skin. The sural lateral artery, the peroneal artery, the lateral posterior malleolus artery, the perforating branches of the heel lateral artery, and the musculocutaneous perforators from the gastrocnemius formed a vascular chain for the sural nerve and lesser saphenous vein. The distally based compound flaps of sural nerve and lesser saphenous vein were applied for the reconstruction of 20 patients in the present study, from January 2004 to January 2007. The musculocutaneous flaps were applied for the repair of lower leg ulcers, osteomyelitis, or bone exposures in 10 cases and for medial calcaneus osteomyelitis in 3 cases. The osteocutaneous flaps and the myo-osteocutaneous flaps were used for tibial bone defects in 7 patients. In the 5- to 18-month follow-ups, all cases presented with survived flaps, healed wound surfaces, and with osteomyelitis. The musculocutaneous flaps were satisfactory and the appearance and movement of the donor site was normal. The transplanted fibulas of the patients with bone defects were healed after 3 to 4 months on average with a recovery of the ability for movement and support. The distally based compound flap pedicled with the nutrient vessel of sural nerve and lesser saphenous vein was convenient and reliable to employ due to its advantages of infection control, high percentage survival, and rapid healing. It was satisfactorily adapted for reconstruction of leg bone defects, missing skin, and foot and ankle defects.

To explore the effect of transferring adjacent non-main vessel pedicle flap on repairing the heel skin defect.From February 2000 to April 2004, 4 kinds of flaps with non-main vessel pedicle were used to repair 30 cases of heel skin defect. Of the 30 patients, 19 were male and 11 were female, whose ages ranged from 8 to 65. Among them, 19 cases were crush injury, 5 cases were press injury, 3 cases were electric saw injury, 2 cases were osteomyelitis, and 1 case was squamous cell carcinoma. Fourteen cases were with defect area ranged from 6.0 cm x 5.5 cm to 16.5 cm x 11.0 cm. All the 14 cases were repaired with distant pedicled sural vascular flap of nutrient vessels and saphenous vascular flap of nutrient vessels. The sizes of the dissected flap ranged from 6.0 cm x 5.0 cm to 18.0 cm x 12.0 cm. And the other 16 cases with defect area ranged from 2.5 cm x 2.0 cm to 5.5 cm x 4.5 cm were repaired with foot lateral flap and foot base medial flap. The sizes of the dissected flap ranged from 4.0 cm x 3.0 cm to 8.0 cm x 7.0 cm.All cases were followed up for 6 to 12 months. The flaps all survived with satisfactory appearance and no ulceration. Callus appeared in 2 cases. The sense of pain and touch was partly or completely restored. The two-point discrimination sense recovered to 1.0-3.2 cm.As it is easily accessible, highly flexible and causes little damage to blood circulation, transferring adjacent non-main vessel pedicle flap, is effective in repairing foot heel skin defect.