RESUMEN

Coxsackievirus B1 (CVB1), an enterovirus with multiple clinical presentations, has been associated with potential long-term consequences, including hand, foot, and mouth disease (HFMD), in some patients. However, the related animal models, transmission dynamics, and long-term tissue tropism of CVB1 have not been systematically characterized. In this study, we established a model of CVB1 respiratory infection in rhesus macaques and evaluated the clinical symptoms, viral load, and immune levels during the acute phase (0-14 days) and long-term recovery phase (15-30 days). We also investigated the distribution, viral clearance, and pathology during the long-term recovery period using 35 postmortem rhesus macaque tissue samples collected at 30 days postinfection (d.p.i.). The results showed that the infected rhesus macaques were susceptible to CVB1 and exhibited HFMD symptoms, viral clearance, altered cytokine levels, and the presence of neutralizing antibodies. Autopsy revealed positive viral loads in the heart, spleen, pancreas, soft palate, and olfactory bulb tissues. HE staining demonstrated pathological damage to the liver, spleen, lung, soft palate, and tracheal epithelium. At 30 d.p.i., viral antigens were detected in visceral, immune, respiratory, and muscle tissues but not in intestinal or neural tissues. Brain tissue examination revealed viral meningitis-like changes, and CVB1 antigen expression was detected in occipital, pontine, cerebellar, and spinal cord tissues at 30 d.p.i. This study provides the first insights into CVB1 pathogenesis in a nonhuman primate model of HFMD and confirms that CVB1 exhibits tissue tropism following long-term infection.

Asunto(s)

Modelos Animales de Enfermedad , Enterovirus Humano B , Enfermedad de Boca, Mano y Pie , Macaca mulatta , Carga Viral , Tropismo Viral , Animales , Enfermedad de Boca, Mano y Pie/virología , Enfermedad de Boca, Mano y Pie/patología , Enterovirus Humano B/fisiología , Enterovirus Humano B/patogenicidad , Anticuerpos Antivirales/sangre , Anticuerpos Neutralizantes/sangre , Anticuerpos Neutralizantes/inmunología , Animales Recién Nacidos , Citocinas/metabolismo

RESUMEN

Objective:To investigate the curative effect of transfer of free anteriolateral thigh flap (ALTF) with partial iliotibial tract on reconstruction of composite tissue defects in dorsal wrist/hand.Methods:Ten patients who were admitted in the Department of Hand Surgery of Yongkang Orthopaedic Hospital from March 2018 to August 2022 were entered in the study due to extensive composite tissue defects in dorsal wrists and hands. The patients were 24-48 (37 in average) years old. All patients had tendon defects in 3 or more digits with 35 digits in total. The length of the tendon defects were 5.0-11.0 cm in various digits. The soft tissue defects ranged from 6.0 cm×8.0 cm to 11.0 cm×21.0 cm in size. Six patients had defects accompanied with metacarpal and phalangeal bone fracture and joint capsule. In emergency surgery, all patients received thorough debridement and VSD coverage after internal fixation for combined fractures. At 3-5 days after the primary surgery, free ALTF transfer with partial iliotibial tract was employed to reconstruct the defects on dorsal wrists and hands and the digit extension function. The size of flap was 6.0 cm×9.0 cm-9.0 cm×17.0 cm, and the rest of defect wound was covered by skin graft. All the donor sites were sutured directly, except 1 that received abdominal skin graft. Patients had the follow-ups in outpatient clinics, or via telephone or Wechat, to observe the sensation and appearance of the flap, and the healing of the donor site. The recovery of the extension function of the hand was evaluated according to the totle active motion (TAM) system.Results:All flaps survived except one that had vascular compromise after the surgery and it survived after two explorations and a vascular transfer. Postoperative follow-ups lasted for 6 to 24 months, with 13 months in average. At the last follow-up, a all the flaps were found soft in texture and slightly swollen in appearance. There was no obvious pigmentation or rupture of skin and extensor tendon. Sensory recovery achieved to S 2 in 7 patients and S 3 in 3 patients. The hand function was evaluated according to TAM system and rated as excellent for 3 digits, good for 18 digits, fair for 9 digits and poor for 5 digits. There were linear scars in the donor sites. Conclusion:Free ALTF transfer with partial iliotibial tract in the reconstruction of composite tissue defect of dorsal wrists and hands can not only reconstruct the wound surface, but also the extension of digits, which cuts short the course of treatment.

RESUMEN

Objective:To compare short-term and long-term curative effect of modified double Kirschner wire open reduction and internal fixation (ORIF) and traditional surgery on patients with mallet fingers of avulsion fracture type.Methods:Eighty-five patients with mallet fingers of avulsion fracture type who were admitted to Yongkang Orthopaedic Hospital from January 2016 to October 2018 were enrolled. 45 patients received modified double Kirschner wire ORIF were included in the observation group, while 40 patients who underwent traditional extracting wire fixation were included into control group. The operation time, fracture healing time and complications were recorded. At 3 months after surgery, short-term curative effect was evaluated. After 1-year postoperative follow-up, long-term prognosis was evaluated by finger joint function scoring.Results:The operation time of observation group was shorter than that of control group ( P<0.05). The fracture healing time of observation group was shorter than that of control group ( P<0.05). The good rate of observation group was higher than that of control group (93.33% vs 77.50%) ( P<0.05). In finger joint function score, scores of finger strength, finger flexibility, effects on work and life, and total score in observation group were higher than those in control group ( P<0.05). There was no significant difference in pain degree or appearance satisfaction betwen the two groups ( P>0.05). There was no significant difference in incidence of postoperative complications between the two groups ( P>0.05). Conclusions:The modified double Kirschner wire ORIF for the treatment of avulsion fracture mallet finger has the advantages of simple operation, fast fracture healing and better long-term and short-term curative effect than the traditional wire extraction method.