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Objective:To investigate various clinical treatment measures for thoracolumbar fractures and provide new diagnosis and treatment methods.Methods:The case data of 5 patients(3 males, 2 females, and the age ranged from 39 to 59 years with an average of 51 years) with thoracolumbar fractures were treated with Waveflex semi-rigid internaI fixation system from May 2020 to December 2021 were retrospectively analyzed, imaging indexes and clinical effects were followed up, and analyzed and summarized in combination with relevant literatures.Results:The operations of all 5 patients were successfully completed, and the follow-up period was 6 months. At the last follow-up, the internal fixation position was good, the height of the injured vertebra was maintained satisfactorily, and the clinical effect was satisfactory.Conclusion:Waveflex semi-rigid internal fixation system combines the advantages of fusion and non-fusion, providing a new idea for the treatment of thoracolumbar fractures, but its long-term effect still needs further follow-up.
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ObjectiveTo analyze the application of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in China. MethodsResearches using ISNCSCI in the spinal cord injury were retrieved from CNKI, from January 1st, 2020 to December 31st, 2022. The authors and the keywords of the included literatures were analyzed using VOSviewer and CiteSpace to generate a collaboration network graph of authors and a theme distribution map of keywords. The objects, purposes, causes of spinal cord injury, distribution of researchers' departments, ISNCSCI version used, corresponding publication time and other information of the included studies were manual searched and analyzed. ResultsA total of 285 literatures were finally included, involving 1 279 authors, out of whom 111 published 97.19% of the total number of articles. The main keywords included spinal cord injury, spinal fractures, neurological function, thoracolumbar fractures and spinal tuberculosis, which classified in seven clusters, and the topics of spinal cord injury, efficacy, spinal fractures, quality of life and prognosis were the hotspots in the field. With manual searching, the main topic was spinal cord injury; the main object was traumatic spinal cord injury; the main purpose was to evaluate the surgical efficacy; the research institutions were mostly the comprehensive hospitals or specialized hospitals focusing on orthopedics (spinal surgery); the clinical departments that used ISNCSCI the most were orthopedics (including spinal surgery) and rehabilitation medicine, and nursing teams were paying more attention to ISNCSCI; the most commonly used versions of ISNCSCI were 2011 (7th edition) and 2000 (6th edition), however, for a large number of articles, the versions were not clear or earlier than 2000. ConclusionThe application of ISNCSCI in China should be improved in the standardization.
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Objective@#To investigate an incident of mushroom poisoning and related clinical data.@*Methods@#A descriptive analysis was performed to investigate an incident of poisonous mushroom poisoning in Jinan, Shandong Province, China in July 2016. The clinical data of four patients were analyzed and summarized, and the causes of this incident and prevention and control measures were summarized.@*Results@#This incident of acute poisonous mushroom poisoning was caused by Lepiota brunneoincarnata. The patients mainly had digestive system symptoms, including nausea, vomiting, and severe abdominal pain, and later developed liver damage. After comprehensive rescue treatment, one patient died and three survived. The main clinical manifestation of the patient who died was multiple organ failure, especially liver failure.@*Conclusion@#This incident of poisoning was caused by Lepiota brunneoincarnata the residents ate by mistake.
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Objective@#To investigate the causes of peripheral vascular thrombosis in patients with paraquat poisoning.@*Methods@#The patients with paraquat poisoning who were admitted to our department in recent two years were observed to screen out the patients with large vessel thrombosis. The data on toxic exposure history, clinical features, and treatment were collected to analyze the causes of thrombosis in the patients with paraquat poisoning.@*Results@#Three patients had typical lower limb thrombosis. There was one case of right common femoral vein thrombosis, one case of bilateral calf muscle vein thrombosis, and one case of right calf superficial vein thrombosis and right calf muscle vein thrombosis.@*Conclusions@#After paraquat poisoning, the blood is in a hypercoagulable state and prolonged bed rest may increase the risk of thrombosis.
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Objective To investigate the clinical efficacy of a novel acetabulum anatomic locking plate in the treatment of anterior wall and anterior column acetabular fracture.Methods A retrospective case series study was performed in five patients with anterior wall and anterior column acetabular fractures managed operatively using a novel acetabulum anatomic locking plate from March 2014 to January 2016.There were four males and one female,with an average age of 41.1 years (range,25-65 years).The mean time from injury to operation was 3.2 days (range,2-5 days).All patients were managed operatively using the superior ilioinguinal approach.Operation duration,intraoperative blood loss,blood transfusion,and bony union time were recorded.The image results by Matta standard were evaluated and the acetabular function after operation was assessed by modified Merle d'Aubigné-Postel.Postoperative complications were recorded.Results All patients were followed up for average 15.3 months (range,12-24 months).The average operation duration was 96 minutes (range,60-130 minutes) and average blood loss was 230 ml (range,100-800 ml).Autologous blood transfusion was selectively used except for one patient with allogeneic blood transfusion of 400 ml.The mean time of bony union was 2.9 months (range,2-5 months).According to the Matta criteria,four patients attained anatomical reduction,and unsatisfactory reduction was reported in one patient.Clinical outcomes (Merled'Aubigné-Postel) at 12 months were 100％ excellent with the average score of 17.1 (range,15-18).One patient had a lateral cutaneous nerve palsy,and symptom relief was seen after a follow up of 6 months.After operation,no complications such as surgical site infection,femoral head avascular necrosis,andtraumatic arthritis occurred in any patient.Conclusion The novel acetabulum anatomic locking platecan provide rigid and firm fixation for both anterior wall and anterior acetabular fractures using one singleplate,and the fracture reduction and function recovery are satisfactory.
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Objective@#To explore the acute toxicity of Diquat in mice and to calculate the median lethal dose (LD50) of Diquat to rats and observe the pathological changes of tissues and organs in rats with different concentrations of Diquat.@*Methods@#Diquat solution of 50 mg/kg was prepared freshly with 1 000 mg of Diquat and dilute the solution with water to a total of 20 ml. A total of 99 healthy adult male Wistar rats were randomly divided into part one, part two and control groups. In the first part, 36 rats were randomly divided into 4 groups: 100 mg/kg group, 200 mg/kg group, 300 mg/kg group and 400 mg/kg group, which were treated with 100 mg/kg, 200 mg/kg, 300 mg/kg and 400 mg/kg of Diquat solution by gavage, respectively. The death and symptoms of poisoning after intragastric administration were recorded, and the maximum tolerated dose and absolute lethal dose were measured. In the second part, 54 rats were randomly divided into 6 groups: 200 mg/kg group, 220 mg/kg group, 240 mg/kg group, 260 mg/kg、280 mg/kg group and 300 mg/kg group, whichwere treated with 200 mg/kg, 220 mg/kg, 240 mg/kg, 260 mg/kg, 280 mg/kg and 300 mg/kg of Diquat solution by gavage, respectively. The survival of rats in different concentration of Diquat was observed and the LD50 was calculated by Excel processing the formula of Koch's method. The control group were given equal volume water under the same experimental conditions. And moreover, the lungs, kidneys, hearts, livers, and brain tissues were collected and fixed by formaldehyde, embedded by paraffin, and sectioned for histopathological light microscopy.@*Results@#The maximum tolerated dose was 240 mg/kg and the absolute lethal dose was 300 mg/kg. The LD50 of Diquat for Rats was 280.58 mg/kg. The high-dose group had significantly more organ damage than the low-dose group after diquat poisoning.@*Conclusion@#The determination of the half-lethal dose of diquat, at the same time observed multiple organs damaged in rats after the diquat quickly poisoned. Kidneys, lungs and heart might be the main organ which was heavily damaged. With the extension of observation time, the organ damage of rats exposed to small doses gradually stabilized.
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Objective@#To investigation to an accident of occupational trichloroethylene explosion and analyze the clinical datas.@*Methods@#An investigation was carried out on the explosion of trichloroethylene in a place in shandong province in June 2016, and the clinical data of 4 patients with trichloroethylene poisoning were analyzed.@*Results@#The incident is caused by irregularities in workers, 4 patients were characterized by different levels of the respiratory system, nervous system, liver, and skin lesions. Among them, respiratory system damage was more prominent, mainly manifested as chemical bronchitis and pneumonia, after positive rescue and treatment all recovered and discharged.@*Conclusions@#Trichloroethylene leak can cause severe ex-plosion accidents, can cause workers of the respiratory system, nervous system, liver and skin lesions, mainly glucocorticoids comprehensive therapy has good curative effect.
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Objective To investigate the effect of autologous platelet rich plasma along with bone transportation in tibia defect.Methods This was a randomized single-blind placebo controlled clinical trial.From Jan 2013 to Mar 2015,28 patients (28 cases) suffering from tibia defect because of trauma or osteomyelitis were randomly assigned to PRP group (PRP along with bone transportation,n=15) or bone transportation group (bone transportation only,n=13) through random number table and sealed envelop method.PRP group:male to female 12∶3,average age:40.9 years old,average bone defect:7.1 cm,6 caused by trauma,9 by osteomyelitis;while bone transportation group:male to female 10∶3,average age:37.7 years old,average bone defect:6.5 cm,3 caused by trauma and 10 by osteomyelitis.Bony results and tibia function were evaluated according to the Association of the Study and Application of the Method of Ilizarov (ASAMI) protocol.The external fixation index,complications and VAS pain score were also evaluated.Results The mean follow-up time was 21.8 m in PRP group and 23.2 m in bone transportation group and there were no loss to follow-up.There were no differences between two groups on postoperative VAS pain score:1st d postoperative (3.33±2.58 vs 4.46±2.73);7th d postoperative (2.67±2.09 vs 3.00±2.20);and 2 weeks postoperative (1.46± 1.77 vs 2.62±2.72).There was significant difference between two groups on external fixation index (37.9±7.7 d/cm vs 46.9± 13.7 d/cm).According to the ASAMI protocol,all patients achieve bone union,except 2 cases in control group which need revision surgery;excellent and good rate of bone defect union was 93％ in PRP group while 77％ in control group;while no difference was found on complication and lower extremity function.Conclusion Application of PRP along with bone transportation in the treatment of tibia defect resuits in shorter healing duration and external fixation duration.But no short-term postoperative analgesic effect,lower extremity function,and complication rates were found.
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Objective To explore the design of a novel acetabulum anatomic locking plate and the clinical application for both column and quadrilateral surface fractures.Methods Clinical and follow-up data of 6 patients with both column fractures involving the quadrilateral plate managed operatively by a novel acetabulum anatomic locking plate from July 2014 to April 2015 were retrospectively analyzed.Among them 4 cases were male and 2 cases were female,with an average age of 35.1 years old (range,24-52 years old).The mean time from injury to operation was 7.2 d (range,2-12 d).According to the fracture classification of Letournel-Judet,there were all associated with two column fractures involving the quadrilateral plate..All patients managed operatively by the novel acetabulum anatomic locking plate,which can simultaneous manage both column and quadrilateral surface fractures through the single superior ilioinguinal approach.The image results by Matta standard were evaluated and the results of acetabular function after surgery were assessed by Merle d'Aubigne-Postel.Results The 6 patients were followed up for at least 14 months (range,12-22 months).Average blood loss was 860 ml,and average operative time was 286 min.The mean time of bony union was 4.3 months.According to the criteria described by Matta,66.7％ of the reductions were graded excellent,16.7％ were graded good,and 16.7％ were poor.Clinical outcomes (Merle d'Aubigne-Postel) at 12 months were 66.7％ excellent,16.7％ good,and 16.7％ poor.One patient (4.5％) had an iatrogenic injury of internal iliac artery during operation.Unilateral iliac artery embolization was performed.One patient had a fatty fluidization.No surgical site infection,femoral head avascular necrosis and traumatic arthritis occurred.Conclusion The novel acetabulum anatomic locking plates for both column and quadrilateral surface can provide strong and stable fixation for complex acetabular fractures through the single superior ilioinguinal approach.It can achieve satisfactory reduction and approving clinical functions.