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Tibial plateau fracture,one of the most common fractures,includes simple and complicated fractures.Inappropriate treatment could result in pain and deformity,which has a bad effect on patient life.With the development of the surgical technique,a lot of methods could be selected when an orthopedist deals with these fractures.X-ray,one of the most common assistant examination,is the preferred method for tibial plateau fracture and could diagnose most of these fractures.Due to high resolution,CT scan could find these micro-fractures which X-ray cannot find and it could supplement the Schatzker type.MRI could find ligament,meniscus and arthrodial cartilage injury.Surgical approach includes anterolateral approach,medial approach,posteromedial approach,post approach,anterior approach.Anterolateral approach could be used for most of tibial plateau fractures.Posteromedial approach is used for medial plateau fracture involving post plateau fracture or post plateau fracture alone.Common plate,locking plate,dual plate and external fixation are commonly used fixation method.Dual plate is often used for complicated tibial plateau fracture.However,how to make accurate diagnosis and choose appropriate fixation is crucial for patients.We will summarize the application of X-ray,CT scan and MRI in diagnosis of tibial plateau fracture.Commonly used approaches to the proximal tibia,which together allow for the treatment of any proximal tibia fracture,will be described in this article.
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BACKGROUND:A large number of studies have confirmed that anterior approach and posterior approach for multilevel cervical spondylotic myelopathy were effective, but there is stil no conclusion in which one is better. OBJECTIVE:To systematical y assess the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy. METHODS:The databases such as The Cochrane Library (Issue 3, 2013), PubMed (from 1966 to March 2013), OVID (from 1950 to March 2013), EMbase (from 1966 to March 2013), Chinese Biomedical Literature Database (from 1978 to March 2013), WanFang Database (from 1998 to March 2013), China National Knowledge Infrastructure (from 1999 to March 2013) were electronical y searched and five relevant journals were searched by hand to col ect the randomized control ed trials or non-randomized control ed trials about the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. Then the meta-analysis was performed by using RevMan5.2 software. RESULTS AND CONCLUSION:A total of 11 control ed trials involving 814 patients were included. Meta-analysis results showed that, compared with posterior approach, postoperative Japanese Orthopaedic Association scores were better (P<0.000 01), improvement rate of neurological function was higher (P=0.000 3), the incidence of C5 root palsy was lower (P=0.007), but operation time was longer (P<0.000 01), amount of intraoperative bleedin g was larger (P=0.000 7), incidence of adjacent segments degeneration was higher (P=0.01), incidence of postoperative complications was higher (P<0.000 01) and the rate of secondary surgical procedures was higher (P=0.003) after anterior approach. Additional y, there were no differences between the two groups in the cervical range of motion (P=0.56). For quantity limitation and low methodological quality of included studies, this conclusion stil needs to be further proved by performing more high-quality and large-scale randomized control ed trials.
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BACKGROUND:Adipose-derived mesenchymal stem cels are a group of pluripotent stem cels, and under certain conditions can differentiate into neural stem celsin vitro. OBJECTIVE:To investigate the proliferative and differentiation ability of different passage mesenchymal stem cellfrom adipose tissue into neurospheres. METHODS:The adipose-derived mesenchymal stem cels from Sprague-Dawley rats were separated and culturedin vitro, and morphology and proliferation rate of cels were observed and compared respectively at passages 3, 6, 10 and 20. The cellsurface antigens and cels cycle were identified by flow cytometry. Furthermore, adipose-derived mesenchymal stem cels were induced into neurospheres, and the neurosphere rate was counted. RESULTS AND CONCLUSION: Adipose-derived mesenchymal stem cels were mainly in long spindle shape, and cels at different passages had highly proliferative capacity in vitro. Except passage 3, adipose-derived mesenchymal stem cels strongly expressed CD29, CD44, CD73 and lowly expressed CD45 and CD34. The proportion of G0/G1 phase in cellcycle was 93.4% at passage 3, 92.7% at passage 6, 92.4% at passage 10, 86.0% at passage 20. Adipose-derived mesenchymal stem cels at passages 6 and 10 were easier to differentiate into neurospheres than those at passage 20 (P < 0.05), but cels at passage 3 were difficult to differentiate into neurospheres. Therefore, when using adipose-derived mesenchymal stem cels as seed cels, we should pay attention to choose the appropriate amplification passage in order to obtain the cels with best differentiation potential and cellpurity.
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BACKGROUND:Telomerase reverse transcriptase (TERT) plays an important role in telomerase activation, however there is rare report addressing the construction of the lentivirus targeted its genes to inhibit its expression in the spinal cord astrocytes. OBJECTIVE:To construct recombinant lentivirus vector expressing smal interfering RNA against TERT gene and to evaluate its potential for inhibiting the TERT expression. METHODS:After shRNA-TERT sequence was designed and synthesized, the sequence was amplified by PCR and then connected to plasmid pLentilox3.7U6-hTERT to construct recombinant plasmid. The recombinant plasmid was then transfected to DH5αcel s to screen positive colony, and the sequence was identified. The recombinant plasmid pLentilox3.7U6-TERT was transfected in 293T cel s, generating recombinant lentivirus Le-TERT. The titer of recombinant lentivirus was determined and Le-TERT was transfected into the rat spinal cord astrocytes. The expression of TERT in astrocytes was detected by RT-PCR, western blot and immunofluorescence assay. RESULTS AND CONCLUSION:The gene sequencing analysis confirmed that, recombinant plasmid pLentilox3.7U6-TERT was successful y constructed. The real-time quantitative PCR, western blot analysis and immunofluorescence assay indicated that, after Le-TERT was transfected in the astrocytes for 4 days, the inhibition rate of TERT mRNA was (63.98±2.6)%, and Le-TERT was lowly expressed in the transfected astrocytes. Recombinant expression vector pLentilox3.7U6-TERT can produce the lentivirus at high titer and effectively inhibit TERT expression in the transfected astrocytes.
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<p><b>BACKGROUND</b>The objective of this study was to analyze the trend in the publication of systematic reviews on hip fractures through a bibliometric approach.</p><p><b>METHODS</b>Literature including systematic reviews or meta-analyses on hip fractures was searched from the ISI Web of Science citation database. The search results were analyzed in terms of geographical authorship and frequency of citation by country, institution, author, and periodical distribution.</p><p><b>RESULTS</b>A total of 654 published systematic reviews from 1995 to 2013 in 48 countries or regions were retrieved. The United States (171) was the predominant country in terms of the number of total publications, followed by the United Kingdom (149), Canada (120), Australia (76), and China (54). The number of systematic reviews significantly increased during the last 6 years, especially in China. The production ranking changed in 2012, at which time the United States and China were the leaders in the yearly production of systematic reviews on hip fractures. The amount of literature (27 publications) from China contributed almost one-quarter of the total literature (109 publications) in 2012. However, the average number of citations of each article from China was still low (6.70), while the highest number of citations of each article was from Sweden (193.36). The references were published in 239 different journals, with 15 journals contributing to 41.3% of the systematic reviews on hip fractures. The two journals that contributed the most were Osteoporosis International (10.6%) and the Cochrane Database of Systematic Reviews (7.6%). The predominant institution in terms of the number of publications was McMaster University (36) in Canada.</p><p><b>CONCLUSIONS</b>The best evidence in the field of hip fractures has attracted increasing attention. Systematic reviews on hip fractures from China have been increasingly more frequent during the past 6 years, particularly in 2012.</p>
Subject(s)
Humans , Bibliometrics , Hip Fractures , PublicationsABSTRACT
BACKGROUND:The surgical method for the treatment of unstable distal radius fracture mainly includes plate internal fixation and external fixator, but both of these two methods have the advantages and disadvantages. Which treatment is more conducive to the rehabilitation of patients, there is stil controversy. OBJECTIVE:To evaluate the clinical effectiveness of internal fixation and external fixator for the treatment of unstable distal radius fractures. METHODS:The relative databases and literatures were searched with the computer and hand to col ect the randomized control ed trials of internal fixation versus external fixator for the treatment of unstable distal radius fractures. After extraction literature data and quality evaluation, RevMan 5.2 software was used for system evaluation. The grip strength, disabilities of arm, shoulder&hand score, complications rates, infection rates, deformity rates and ulnar variance rates were compared between two groups. RESULTS AND CONCLUSION:A total of 9 literatures, involving total y 524 patients were included, 286 patients in the internal fixation group and 238 patients in the external fixator group. There was no significant difference in grip strength between internal fixation group and the external fixator group. The results of Meta-analysis showed that the internal fixation group was better than the external fixator group in the aspects of disabilities of arm, shoulder&hand score, complications rate, infection rate, deformity rate and ulnar variance rate at 3 months and 1 year after treatment. The results indicate that the plate internal fixation is better than external fixator in the treatment of unstable distal radius fractures, but the large sample, double-blind, and high quality randomized control ed trials are stil needed to identify the results.