In nonhealing venous ulcers there is a consistently high level of expression of VEGF, at both the gene transcript and protein level. As our previous data demonstrated that angiogenesis is depressed in these poorly healing ulcers, an increase in VEGF production may indicate an increased but ineffectual angiogenic drive. It is also possible that undiscovered inhibitors are released in the ulcer environment.

The purpose of this study was to determine the effect of low-dose doxycycline on matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase (TIMP)-1 expression in the wall of abdominal aortic aneurysms. A double-blind, randomized study was conducted of patients treated with doxycycline (100 mg/d orally) or placebo for 1 month prior to surgery. MMP-2, -3, and -9 (zymogen and activity); MMP-1, -2, -3, -7, -9, -11, -12, and -14; and TIMP-1 (messenger ribonucleic acid [mRNA]) were measured in the aneurysm wall. No differences were found between the treatment and placebo groups in zymogen levels of MMP-2, -3, or -9 or in the free or total activities of MMP-2 and -9. Treatment with doxycycline also had no effect on the concentration of any mRNA measured. No relationship was found between the number of tablets taken and MMP or TIMP protein, mRNA, or activity levels in the aneurysm wall. Low-dose doxycycline treatment does not alter the expression or activity of metalloproteinases or their inhibitor, TIMP-1, in the aneurysm wall.

The insertion/deletion (I/D) polymorphism of the gene encoding angiotensin converting enzyme is a controversial risk factor for restenosis after percutaneous transluminal coronary angioplasties (PTCA) in patients. Genetic association studies can be problematic to reproduce due to insufficient power, phenotypic heterogeneity, population stratification, small effect of the variant and even publication biases. To derive a more precise estimation of the relationship as well as to quantify the between-study heterogeneity and potential bias, a meta-analysis including 11,193 patients from 33 published cohort studies was performed. In a combined analysis, the summary per-allele odds ratio for restenosis was 1.31 (95% CI: 1.08-1.58, P = 0.006), and 1.22 (95% CI: 0.95-1.56, P = 0.12), for PTCA-stent and PTCA-balloon, respectively. In the subgroup analysis by ethnicity, significantly increased restenosis risks after PTCA-stent were found in Asians for the polymorphism; whereas no significant associations were found among Caucasians. As for restenosis risks after PTCA-balloon, no evidence of any gene-disease association was obtained in the stratified analyses according to ethnicity and study size. In conclusion, this meta-analysis demonstrated that the DD homozygous of ACE I/D polymorphism was significantly associated with elevated restenosis susceptibility after PTCA-stent among Asian populations.

Background Pilon fracture is common clinical joint fracture and difficult to treat. It has high requirements on reduction and fixation. The selection of treatments is challengeable. In order to recover the ankle function maximize, there are many treatments proposed in paper recently, but no further studies. Therefore, patients of our hospital with Pilon fracture were followed up and the treatments were compared by different operations. Materials and methods Eighty-eight patients from August 2003 to October 2010 treated with conservative treatment, open reduction and internal fixation, external fixation combined with limited open reduction and internal fixation and external fixation were retrospectively analyzed. Results Seventy-eight cases were followed up in 88 patients, 66 cases were treated with operation. Postoperative complications: malunion in 7 cases, wound infection and delayed healing in 5 cases, delayed union in 2 cases and traumatic arthritis in 4 cases. At the same time, ankle function of type III Pilon fracture after operation was scored by Tornetta. Conclusion choose a suitable operation style and time according to Pilon fracture type and degree of soft tissue and use external fixator combined with limited internal fixation for fracture reduction properly, a good clinical effect can be achieved after surgery. How to cite this article Chu H, Yu H, Zhu K, Ren D, Xu X, Huang H. Analysis of the Operative Treatment for Pilon Fracture. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):86-89.