BackgroundRelatively few studies have addressed plate osteosynthesis for open proximal tibial fractures by now. The purpose of this study was to assess the results of minimally invasive plate osteosynthesis (MIPO) for open fractures of the proximal tibia.MethodsThirty-four patients with an open proximal tibial fracture were treated by MIPO. Thirty of these, who followed for over 1 year, constituted the subject of this retrospective study. According to the AO Foundation and Orthopaedic Trauma Association (AO-OTA) classification, there were 3 patients of type 41-C, 6 of type 42-A, 8 of type 42-B, and 13 of type 42-C. In terms of the Gustilo and Anderson's open fracture grading system, 11 patients were of grade I, 6 were of grade II, and 13 were of grade III (III-A, 6; III-B, 6; III-C, 1). After thorough debridement and wound cleansing, when necessary, a soft tissue flap was placed. Primary MIPO (simultaneous plate fixation with soft tissue procedures) was performed in 18 patients, and staged MIPO (temporary external fixation followed by soft tissue procedures and subsequent conversion to plate fixation after soft tissue healing) was performed in 12 patients. Results were assessed according to the achievement and time to union, complications (including infections), and function of the knee joint using Knee Society scores. Statistical analysis was performed to identify factors influencing results.ResultsPrimary union was achieved by 24 of the 30 study subjects. Early bone grafting was performed in 6 cases with a massive initial bone defect expected to result in non-union. No patient had malalignment greater than 10°. The mean Knee Society score was 88.7 at final follow-up visits, 23 patients achieved an excellent result, and 7 a good result. There were 3 superficial and 5 deep infections, but none required early implant removal. Functional results were similar for primary and staged MIPO (p = 0.113). Fracture pattern (p = 0.089) and open fracture grade (p = 0.079) were not found to influence the results.ConclusionsIf soft tissue coverage is adequately performed, MIPO could be regarded as an acceptable method for the treatment of open proximal tibial fracture.

The presence of multiple host-specific races in the common cuckoo Cuculus canorus has long been recognized as an evolutionary enigma but how this genetic divergence could be maintained is still equivocal. Some recent studies supported biparental genetic contribution in maintaining the host-races, implying the necessity that they should recognize and mate assortatively with those who belong to the same host-race. One potential mechanism to accomplish this is that males may produce distinctive calls according to host-specific lineages. In order to test this hypothesis, we carried out a comparative study for male cuckoo calls recorded from three distant populations, where two populations share a same host species while the other parasitizes a different host species. Populations with similar habitat structures, maintaining comparable distance interval (ca. 150 km) between neighboring ones, were selected so as to minimize any other causes of vocal differentiation except the pattern of host use. By comparing the vocal characteristics of male cuckoos at the level of individual as well as population, we found that individual males indeed produced different calls in terms of spectral and temporal features. However, these differences disappeared when we compared the calls at the population level according to host species and geographic location. In conclusion, it seems unlikely for the cuckoos to identify the stepparent of male cuckoos based solely on the vocal characteristics, although they may be able to use this cue for individual recognition. Future studies including detailed morphological and genetic comparisons will be worthwhile to further elucidate this issue.

BACKGROUND Psoriasis is a chronic autoimmune disease that usually manifests as a red scaly epidermis, induration, and hyperproliferation of basal keratinocytes. About 2% of the world’s population suffers from psoriasis but there are no clear therapeutics yet. Recently, mesenchymal stem cells (MSCs) have been regarded as a therapeutic alternative for autoimmune diseases, as they possess immunosuppressive effects without risks. Human umbilical cord-derived MSCs effectively regulate immune cells and are characterized by low immunogenicity, which has many advantages in treating immune diseases. CASE SUMMARY The patient was a 47-year-old male, diagnosed with psoriasis in 1995. He had received various treatments for 25 years, but the psoriatic condition was not significantly improved. He was given three rounds of minimally manipulated umbilical cord-derived MSCs over 2 wk. The erythema gradually disappeared. Three months after the 1 st round, all erythema completely disappeared, and the psoriasis did not recur. CONCLUSION Minimally manipulated umbilical cord-derived MSC transplantation can potentially treat patients who suffer from psoriasis.

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