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PURPOSE@#This study was designed to compare the clinical efficacy of "8" and "0" wire fixation systems combined with double-head cannulated compression screws or Kirschner wires for the treatment of transverse patellar fractures.@*METHODS@#From September 2011 to September 2018, patients with closed transverse patellar fractures treated with a double-head compression screw or Kirschner wire were included and analyzed retrospectively. Patients with patellar fractures combined with distal femoral fractures, tibial plateau fracture or preoperative lower limb dysfunction were excluded. The patients treated with the "8" tension band wire fixation system and Kirschner wire were taken as Group A; those treated with the "0" fixation system and Kirschner wire were taken as Group B; those treated with the "8" fixation system and double-head cannulated compression screw were taken as group C; and those treated with the "0" fixation system and double-head cannulated compression screw were taken as group D. Six weeks and one year after the operation and every month from the third month after the operation until the fractures healed, an X-ray examination was performed to identify fracture healing. The time of fracture healing and postoperative complications of the four groups were compared. One year after the operation, knee function was evaluated by Bostman's score.@*RESULTS@#During the study period, 168 patients with patellar fractures were treated by operations, and 88 patients were excluded because the fracture type did not meet the requirements or because there were combined fractures of the distal femur or tibial plateau. As a result, 80 patients were included in this study, 20 in each group. All the patients were followed up for an average period of 12.2 months. Compared with Group A, patients in Group D presented less postoperative discomfort in the prepatellar region, quicker fracture healing, less fixation failure and better postoperative knee function scores (all p 0.05).@*CONCLUSION@#The "0" wire fixation system combined with a double-head cannulated compression screw seems to be more beneficial than the other three fixation systems for the treatment of transverse patellar fractures.
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BACKGROUND@#The proportion of recurrences after discharge among patients with coronavirus disease 2019 (COVID-19) was reported to be between 9.1% and 31.0%. Little is known about this issue, however, so we performed a meta-analysis to summarize the demographical, clinical, and laboratorial characteristics of non-recurrence and recurrence groups.@*METHODS@#Comprehensive searches were conducted using eight electronic databases. Data regarding the demographic, clinical, and laboratorial characteristics of both recurrence and non-recurrence groups were extracted, and quantitative and qualitative analyses were conducted.@*RESULTS@#Ten studies involving 2071 COVID-19 cases were included in this analysis. The proportion of recurrence cases involving patients with COVID-19 was 17.65% (between 12.38% and 25.16%) while older patients were more likely to experience recurrence (weighted mean difference (WMD)=1.67, range between 0.08 and 3.26). The time from discharge to recurrence was 13.38 d (between 12.08 and 14.69 d). Patients were categorized as having moderate severity (odds ratio (OR)=2.69, range between 1.30 and 5.58), while those with clinical symptoms including cough (OR=5.52, range between 3.18 and 9.60), sputum production (OR=5.10, range between 2.60 and 9.97), headache (OR=3.57, range between 1.36 and 9.35), and dizziness (OR=3.17, range between 1.12 and 8.96) were more likely to be associated with recurrence. Patients presenting with bilateral pulmonary infiltration and decreased leucocyte, platelet, and CD4@*CONCLUSIONS@#The main factors associated with the recurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after hospital discharge were older age, moderate severity, bilateral pulmonary infiltration, laboratory findings including decreased leucocytes, platelets, and CD4
Subject(s)
Humans , Age Factors , Blood Cell Count , CD4 Lymphocyte Count , COVID-19/pathology , Cough , Dizziness , Headache , Patient Discharge , Recurrence , Risk FactorsABSTRACT
Natural products have been a major source of leading compounds in drug discovery. How to effectively screen active compounds from complex matrix remains an interesting topic. In this review, we comprehensively summarized advanced liquid chromatography based approaches in natural products screening, including pre-column, on-column and post-column screening methods. Their advantages, disadvantages and prospect are also discussed.
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BACKGROUND/AIMS: Methylation status plays a causal role in carcinogenesis in targeted tissues. However, the relationship between the DNA methylation status of multiple genes in blood leukocytes and colorectal cancer (CRC) susceptibility as well as interactions between dietary factors and CRC risks are unclear. METHODS: We performed a case-control study with 466 CRC patients and 507 cancer-free controls to investigate the association among the methylation status of individual genes, multiple CpG site methylation (MCSM), multiple CpG site heterogeneous methylation and CRC susceptibility. Peripheral blood DNA methylation levels were detected by performing methylation-sensitive high-resolution melting. RESULTS: Total heterogeneous methylation of CA10 and WT1 conferred a significantly higher risk of CRC (adjusted odds ratio [OR(adjusted)], 5.445; 95% confidence interval [CI], 3.075 to 9.643; OR(adjusted), 1.831; 95% CI, 1.100 to 3.047; respectively). Subjects with high-level MCSM (MCSM-H) status demonstrated a higher risk of CRC (OR(adjusted), 4.318; 95% CI, 1.529 to 12.197). Additionally, interactions between the high-level intake of fruit and CRH, WT1, and MCSM on CRC were statistically significant. CONCLUSIONS: The gene methylation status of blood leukocytes may be associated with CRC risk. MCSM-H of blood leukocytes was associated with CRC, especially in younger people. Some dietary factors may affect hypermethylation status and influence susceptibility to CRC.
Subject(s)
Humans , Carcinogenesis , Case-Control Studies , China , Colorectal Neoplasms , DNA Methylation , Freezing , Fruit , Leukocytes , Methylation , Odds RatioABSTRACT
<p><b>OBJECTIVE</b>To explore plantar pressure measurement system in treating the first ray hypermobility.</p><p><b>METHODS</b>From June 2013 to January 2014, 16 female patients (20 feet) with hallux valgus with unstable of the first sequence were treated by first tarsometatarsal joint fusion, aged from 42 to 52 years old with an average of(46.5±2.9) years old, the course of disease was from 3 to 5 years. Twenty healthy female(20 feet) were chosen as control group, and single side were only choose, aged from 41 to 55 years old with an average of(46.8±4.5) years old. Preoperative and postoperative AOFAS score was used to evaluate feet function. Plantar pressure measurement system were applied to compare peak value of the dynamic pressure and impulse indicators of affected feet and control normal feet from the first to the fifth head of metatarsal bone.</p><p><b>RESULTS</b>All patients were followed up from 24 to 30 months with an average of 27.4 months. Hallux valgus deformity of affected feet were corrected, pain and swelling of the second head of metatarsal bone were disappeared. There were statistical differences in AOFAS score between preoperative (45.55±12.28) and postoperative (85.45±6.76). There were significant differences in peak pressure, pressure between affected feet and normal feet of the first and second head of metatarsal bone. Postoperative peak pressure, pressure of the first affected head of metatarsal bone were increased than that of before operation, but no differences compared with control group(>0.05). Postoperative peak pressure, pressure of the second affected head of metatarsal bone were decreased before operation(<0.05), but no meaning compared with control group(>0.05). There were no significant differences compared between the forth and fifth affected head of metatarsal bone and control group(>0.05).</p><p><b>CONCLUSIONS</b>There were obvious differences in pressure of the first and second head of metatarsal bone patients with unstable of the first sequence, the first tarsometatarsal joint fusing could recover plantar pressure of the first and second head of metatarsal bone by plantar pressure measurement system.</p>
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<p><b>OBJECTIVE</b>To investigate the clinical curative effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa(GSB) and cyst wall resection for the treatment of popliteal cysts.</p><p><b>METHODS</b>A retrospective analysis of patients from May 2011 to December 2015. Arthroscopic treatment for 41 patients with popliteal fossa cysts, 18 males and 23 females, aged from 34 to 67 years old, averaged 42.6 years old. All the patients had preoperative magnetic resonance imagings to confirm the diagnosis and identify the valvular opening(Gastrocnemius-Semimembranosus bursa, GSB), as well as the associated intra-articular pathology. All the popliteal cysts were unilateral, including 26 cases of right knees and 15 cases of left knees. Five patients had recurrent popliteal cysts, and all of them underwent initial open Surgery. The duration from initial surgery to the recurrence ranged from 6 to 17 months(averaged, 11 months). All the patients had underwent arthroscopic treatment of internal drainage by expanding GSB and cyst wall resection. According to the Rauschning and Lindgren classification, 5 cases were grade I , 30 cases were grade II and 6 cases were grade III. Preoperative Lysholm score, 83.19±6.12 (ranged form 73 to 95).</p><p><b>RESULTS</b>The GSB structure was found in all patients with popliteal cysts during operation, including cartilage degeneration in 33 cases, medial meniscus injury in 27 cases, lateral meniscus injury in 7 cases, free body in 8 cases, pigmented villonodular synovitis in 2 cases, and synovial chondromatosis in 3 cases. There were no complications related to vascular, nerve or surgical incision. All the patients were followed up, and the duration ranged from 8 to 27 months, with an average of 18 months. No recurrence of cysts was found. According to the Rauschning and Lindgren classification, there were 9 cases of grade 0, 27 cases of grade I , 4 cases of grade II, 1 case of grade III. Postoperative Lysholm score:91.32±4.26(ranged from 82 to 98).</p><p><b>CONCLUSIONS</b>Arthroscopic internal drainage by expanding GSB and cyst wall resection surgery in the treatment of popliteal cysts has the advantages of less trauma, faster recovery and low relapse rate, which has a good short-term effect.</p>
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<p><b>OBJECTIVE</b>To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinaculum, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella.</p><p><b>METHODS</b>From March 2010 to May 2016, 35 patients with habitual patellar dislocation were treated with the triad operation, including 14 males, 21 females, ranging in age from 18 to 38 years old, with an average of 25.8 years old. Twelve patients had dislocations on the left knee, and 23 patients had dislocations on the right knee. The changes of Q angle, TT-TG value and Kujala score were compared before and after operation.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 9 to 35 months (mean, 23 months). The Q angle of male group was improved from preoperative (29.2±2.0)° to postoperative (14.8±1.2)°(<0.05), and the Q angle of female group was improved from preoperative(30.6±2.3)° to postoperative (16.7±1.5)° (<0.05). CT showed that the TT-TG value was improved from preoperative (20.3±2.2) mm to postoperative (10.3±1.2) mm (<0.05). The Kujala score was improved from preoperative 47.8±7.5 to postoperative 88.4±6.2 (<0.05).</p><p><b>CONCLUSIONS</b>The triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinacular, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella has good short-term clinical effects.</p>
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<p><b>OBJECTIVE</b>To evaluate clinical results of plate on the metatarsal side to reconstruction of tarsometatarsal joint dislocations secondary to diabetic charcot foot.</p><p><b>METHODS</b>Seven patients (9 feet) patients with tarsometatarsal joint dislocations secondary to diabetic charcot foot were treated with plating from April 2012 to December 2014. All patients were male, and 5 cases were on the unilateral side and 2 cases were on the bilateral sides. The age of patients ranged from 45 to 52 with an average of 48 years old. The history of diabetics was from 6 to 15 years. X-ray and CT were used to evaluate fractures healing,and AOFAS was applied to estimate recovery of joint function.</p><p><b>RESULTS</b>All patients were followed up from 12 to 24 months with an average of 19 months. All incisions were healed at stage I . No infection, loosening and breakage of internal fixation, bone nonunion were found after operation. According to postoperative X-ray and CT results, the time of fracture healing ranged from 10 to 20 weeks with an average of 16 weeks. Six feet got excellent results, 2 good and 1 moderate based on AOFAS scoring.</p><p><b>CONCLUSION</b>Tarsometatarsal joint dislocations secondary to diabetic charcot foot treated with plate on the metatarsal side could obtain stable fixation and got satisfied early clinical results.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Bone Plates , Diabetes Complications , General Surgery , Diabetes Mellitus, Type 2 , Foot Diseases , General Surgery , Fracture Fixation, Internal , Joint Dislocations , General Surgery , Metatarsal Bones , General Surgery , Tarsal Joints , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical results of dorsal approach and Weil osteotomy in treating the injury of the plantar plate in second metatarsophalangeal joint.</p><p><b>METHODS</b>Eight feet with plantar plate tear in five cases were treated by plantar plate repairment through dorsal approach and Weil osteotomy from June 2012 to December 2013. The mean age of the patients was 52 years old. All the patients were followed up for 6 to 12 months. American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) were used to evaluate the clinical effect.</p><p><b>RESULTS</b>The second metatarsophalangeal joint stability recovered and the pain released in all patients. Postoperative VAS was lower and AOFAS was higher than preoperative.</p><p><b>CONCLUSION</b>Combined dorsal approach and Weil osteotomy can effectively release the pian of plantar plate, stabilize the metatarsophalangeal joint, decrease the incidence rate of postoperative subluxation and anchylosis in treating plantar plate tears in the second metatarsophalangeal joint.</p>
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Female , Humans , Middle Aged , Joint Instability , General Surgery , Metatarsophalangeal Joint , Wounds and Injuries , General Surgery , Osteotomy , Methods , Plantar Plate , Wounds and InjuriesABSTRACT
Percutaneous pelvic fixation is possible with the advances in intraoperative fluoroscopic imaging and other technologies. Percutaneously inserted screws in medullary pubic ramus,iliac wing, and iliosacral bone can stabilize pelvic or acetabular disruptions directly mean while can diminish operative blood loss, shorten operative time, and allow patient's early activity. Complications associated with open surgical procedures are similarly avoided by using percutaneous techniques. Stable and safe percutaneous fixation techniques depend on accurate closed reduction, excellent intraoperative fluoroscopic imaging, and detailed preoperative planning. A thorough knowledge of pelvic osseous anatomy, injury patterns, deformities, and the related intraoperative imagery techniques are essential for doctors to fulfill the operation of percutaneous pelvic fixation. This paper presents an overview of the technique of percutaneous surgery of the pelvis and acetabulum.
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Humans , Acetabulum , Wounds and Injuries , Fracture Fixation, Internal , Methods , Pelvic Bones , Wounds and InjuriesABSTRACT
<p><b>OBJECTIVE</b>To investigate the long-term results of modified Jaslow technique to treat isthmic spondylolisthesis.</p><p><b>METHODS</b>From April 2000 to January 2002, 75 patients with isthmic spondylolisthesis (Meyerding grade I had 24 cases, grade II had 35, grade III had 16)were treated with a modified Jaslow technique using one single fusion cage on the symptomatic side. There were 35 males and 40 females with an average age of 40 years old, ranging from 23 to 71 years. Clinical symptoms included intermittent claudication, radicular pain and low back pain. Pre- and postoperative percentage slip, lumbar lordosis, height ratio of intervertebral space and the fusion ratio were analyzed according to radiographic conditions; Visual Analogue Pain Score (VAS), Oswestry Disability Index (ODI), Houshuxun criterion were applied to assess the pain and the conventional functions.</p><p><b>RESULTS</b>All patients were followed up from 48 to 62 months with an average of 50.2 months. The percentage slip reduced from 35.6% preoperative to 9.7% at the last follow-up (corrected 72.8%), lumbar lordosis from (53.6 +/- 15.7) degrees to (51.2 +/- 17.1) degrees and the height ratio increased from (58.6 +/- 12.3)% to (91.5 +/- 11.2)%, the rate of fusion was 97.3% (73/75) at the last follow-up. The mean VAS and ODI before operation was (6.2 +/- 2.5) scores and (47.8 +/- 10.3)%, respectively, decreased to (2.5 +/- 1.9) scores and (10.3 +/- 3.0)% at the last follow-up. There was statistical significance in all items except for lumbar lordosis. According to Houshuxun criterion, the results was excellent in 53 cases, good in 12, fair in 8 and poor in 2, the rate of excellent and good was 86.7%. Complication included 2 case internal fixation failure, 3 cases transient neurologic deficits and 3 cases pseudoarticulation formation.</p><p><b>CONCLUSION</b>The modified Jaslow technique is suitable for isthmic spondylolisthesis (Meyerding I - III), which has advantage of sufficient decompression, solid fixation and can obtain satisfactory clinical results with long-term follow-up.</p>
Subject(s)
Female , Humans , Male , Follow-Up Studies , Lumbar Vertebrae , General Surgery , Spinal Fusion , Methods , Spondylolisthesis , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To summarize the experience on auto-pulmonary transplantation (Ross procedure) treating with congenital aortic disease.</p><p><b>METHODS</b>From October 1994 to November 2003, 20 cases of Ross procedure were performed to treat with congenital aortic disease, Male: 15 cases; Female: 5 cases; age: 25 years;</p><p><b>DIAGNOSIS</b>congenital heart disease (CHD), aortic abnormalities: 12 cases; aortic valve prolapse: 5 cases; aortic valve hypogenesis: 3 cases; combined with subacute bacterial endocarditis (SBE): 4 cases, and ventricle septal defect (VSD): 2 cases; UCG showed aortic stenosis(AS) and/or aortic insufficience (AI) (moderate to severe), Left ventricle diastole diameter (LVDD): (60.51 +/- 11.87) mm, the grade pressure across aortic valve: (27.04 +/- 6.80) mmHg, heart function (NYHA): Class II: 13 cases; Class III: 3 cases; all cases were performed under CPB and moderate hypothermia, the operation procedure was following: (1) taking off auto-pulmonary artery valve; (2) removing dysfunctional aortic valve and auto-transplantation of pulmonary valve on aortic root; (3) putting a pulmonary homograft to rebuild right ventricular outflow tract.</p><p><b>RESULTS</b>The mortality was 0 during stay at hospital, aortic valve function were all normal, LVDD decreased significantly (t = 3.4007, P = 0.0008), the grade pressure across aortic valve was in normal limitation, (6.8 +/- 0.19) mmHg. Follow-up showed heart function was in Class I (NYHA), aortic and pulmonary valve function was very well.</p><p><b>CONCLUSION</b>Ross procedure is a kind of effective alterative operation for treating with congenital aortic valve disease, with good short and middle term results.</p>